Protecting Pharmacies in Medicaid Act

Hozzl · 2025-04-03T13:23:24Z

Explore the details of Senate Bill 927 Protecting Pharmacies in Medicaid Act currently in Congress. Get insights into its purpose, current status, sponsors, and potential impact on undefined. Stay informed on legislative developments.

4/3/2025, 1:23 PM

Summary of Bill S 927

Bill 119 s 927 aims to make changes to title XIX of the Social Security Act in order to ensure that pharmacies are receiving accurate payments under Medicaid and to prevent the use of abusive spread pricing practices within the Medicaid program.

The bill addresses concerns about the way pharmacies are reimbursed for medications provided to Medicaid beneficiaries. It seeks to increase transparency and accountability in the payment process to ensure that pharmacies are fairly compensated for the services they provide.

Additionally, the bill aims to crack down on abusive spread pricing practices, which occur when pharmacy benefit managers (PBMs) charge Medicaid a higher price for a medication than what they pay the pharmacy for it. This practice can result in pharmacies being underpaid for the medications they dispense, leading to financial strain and potentially impacting patient access to care. Overall, Bill 119 s 927 seeks to protect pharmacies from unfair payment practices and ensure that Medicaid beneficiaries have access to affordable medications. It is an important step towards improving the integrity and efficiency of the Medicaid program.

Congressional Summary of S 927

Protecting Pharmacies in Medicaid Act

This bill provides funds beginning in FY2026 for the Centers for Medicare & Medicaid Services to survey retail and non-retail pharmacies (e.g., mail-order pharmacies) to determine average prices of covered outpatient drugs under Medicaid. Pharmacies that fail to participate in the surveys are subject to civil penalties.

The bill additionally provides funds for FY2026 for the Office of the Inspector General of the Department of Health and Human Services to study the results of the survey and report accordingly to Congress.

The bill also requires pass-through pricing models, and prohibits spread-pricing, for payment arrangements with pharmacy benefit managers under Medicaid.

Current Status of Bill S 927

Bill S 927 is currently in the status of Bill Introduced since March 11, 2025. Bill S 927 was introduced during Congress 119 and was introduced to the Senate on March 11, 2025. Bill S 927's most recent activity was Read twice and referred to the Committee on Finance. as of March 11, 2025

Bipartisan Support of Bill S 927

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Unaffiliated Sponsors

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Policy Area and Potential Impact of Bill S 927

Primary Policy Focus

Alternate Title(s) of Bill S 927

A bill to amend title XIX of the Social Security Act to ensure accurate payments to pharmacies under Medicaid and to prevent the use of abusive spread pricing practices under Medicaid.