# Pharmacy Benefit Manager Transparency Act of 2025 - Plain Language Summary

## What This Bill Does

This bill aims to regulate Pharmacy Benefit Managers (PBMs)—companies that manage prescription drug benefits for health insurance plans. The bill prohibits PBMs from engaging in deceptive pricing practices, such as charging health plans one price for a drug while paying pharmacies a different amount and keeping the difference. It also prevents PBMs from arbitrarily cutting pharmacy reimbursements or clawing back (taking back) payments without legitimate reasons like fraud or incorrect claims. Additionally, the bill bans PBMs from retaliating against pharmacies when the federal government reduces reimbursement rates.

## Key Provisions

The bill requires PBMs to be transparent about their finances by disclosing:
- The actual costs and reimbursement amounts for prescription drugs
- All fees, markups, and discounts they charge
- Rebates and payments they receive from drug manufacturers
- Reasons when they move drugs to more expensive insurance tiers
- Any differences in how they treat pharmacies they own versus independent pharmacies

The bill also makes it illegal to submit false information to federal agencies about PBM practices.

## Who Is Affected

**Beneficiaries:** Patients and health plans could benefit from lower drug costs and more transparent pricing. Independent pharmacies would gain protections against unfair payment practices and retaliation. **Regulated Entities:** PBMs and their subsidiaries would face new compliance requirements and restrictions on their current business practices. The bill applies to all PBMs operating in the United States.