Protect Beneficiaries from Middlemen Act

Hozzl · 2025-09-23T17:44:52Z

Explore the details of House Bill 5197 Protect Beneficiaries from Middlemen Act currently in Congress. Get insights into its purpose, current status, sponsors, and potential impact on Health. Stay informed on legislative developments.

9/23/2025, 5:44 PM

Summary of Bill HR 5197

The bill titled "To amend title XVIII of the Social Security Act to limit cost sharing for drugs under the Medicare program," designated as H.R. 5197 in the 119th Congress and introduced on September 8, 2025.

Congressional Summary of HR 5197

Protect Beneficiaries from Middlemen Act

This bill limits cost-sharing for covered drugs under the Medicare prescription drug benefit and Medicare Advantage.

Specifically, for costs above the deductible but below the annual out-of-pocket threshold, the bill limits cost-sharing to the average net price of the drug (i.e., the average amount paid less any rebates) or the cash price (i.e., the price charged to an individual without insurance), whichever is lower.

The Government Accountability Office must report on the bill's implementation.

Read the Full Bill

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Current Status of Bill HR 5197

Bill HR 5197 is currently in the status of Bill Introduced since September 8, 2025. Bill HR 5197 was introduced during Congress 119 and was introduced to the House on September 8, 2025. Bill HR 5197's most recent activity was Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. as of September 8, 2025