Establish federal rules requiring pharmacy benefit managers administering federal health care prescription drug benefits to reimburse in-network pharmacies based on drug acquisition cost plus a limited add-on and a state Medicaid dispensing fee.

A pharmacy benefits manager ... administering prescription drug benefits on behalf of a Federal health care program ... shall ... reimburse an in-network pharmacy for the ingredient cost of a prescription drug in an amount equal to the sum of ... the national average drug acquisition cost ... and ... 2 percent ... or $25, whichever is less; [and] pay an in-network pharmacy a professional dispensing fee that is equal to the professional dispensing fee paid by the State in which the pharmacy is located under title XIX

Auchincloss introduced the Pharmacists Fight Back Act, which would set federal reimbursement standards for PBMs serving federal health care programs.

Text - H.R.9096 - 118th Congress (2023-2024): Pharmacists Fight Back Act | Congress.gov | Library of Congress
secondary · other · model gpt-5.5

A pharmacy benefits manager administering prescription drug benefits on behalf of a Federal health care program shall reimburse an in-network pharmacy for the ingredient cost of a prescription drug based on national average drug acquisition cost or wholesale acquisition cost, plus 2 percent or $25, whichever is less, and pay a professional dispensing fee equal to the State Medicaid dispensing fee.

Auchincloss sponsored the Pharmacists Fight Back Act, which would set federal PBM reimbursement rules for in-network pharmacies in federal health care programs.

H.R.9096 - 118th Congress (2023-2024): Pharmacists Fight Back Act | Congress.gov | Library of Congress
secondary · other · model gpt-5.5

Congress.gov lists Rep. Jake Auchincloss as sponsor of H.R.6609, introduced December 11, 2025. Its latest action was committee referral, and its status is Introduced, not enacted.

Auchincloss introduced a bill matching the Medicare and Medicaid portion of the promise, but the bill had not advanced beyond introduction or become law by the assessment date.

never later_term A for effort

Congress.gov: H.R.6609 - Pharmacists Fight Back in Medicare and Medicaid Act
secondary · model gpt-5.5 · confidence 94%

H.R.6609 would require Medicare Part D and Medicaid PBM reimbursement to use NADAC or WAC, add the lesser of 4 percent or $50, and pay the state Medicaid dispensing fee.

The introduced bill directly tracks the promised reimbursement formula for Medicare Part D and Medicaid, but it is only proposed statutory text.

never later_term A for effort

Congress.gov Text: H.R.6609 - Pharmacists Fight Back in Medicare and Medicaid Act
secondary · model gpt-5.5 · confidence 95%

Congress.gov lists Rep. Jake Auchincloss as sponsor of H.R.6610, introduced December 11, 2025. Its latest action was referral to the House Oversight and Government Reform Committee, and its status is Introduced.

Auchincloss also introduced a companion-style bill for Federal Employee Health Benefit plans, but it likewise had not passed or become law.

never later_term A for effort

Congress.gov: H.R.6610 - Pharmacists Fight Back in Federal Employee Health Benefit Plans Act
secondary · model gpt-5.5 · confidence 93%

H.R.6610 would require PBMs administering FEHB prescription drug benefits to reimburse in-network pharmacies at NADAC or WAC plus the lesser of 4 percent or $50 and pay the state Medicaid professional dispensing fee.

The FEHB bill covers another federal prescription drug benefit program using the promised formula, but it remained proposed legislation rather than established federal rules.

never later_term A for effort

Congress.gov Text: H.R.6610 - Pharmacists Fight Back in Federal Employee Health Benefit Plans Act
secondary · model gpt-5.5 · confidence 94%