PBM Kickback Prohibition Act

Summary#

This bill would change a part of the Employee Retirement Income Security Act (ERISA). It adds a rule that, for contracts between a covered health plan and a pharmacy benefit manager (PBM), the PBM cannot pay money—directly or indirectly—to a brokerage firm, broker, consultant, advisor, or any other person for referring the plan's or insurer's business to that PBM. The change would apply for plan years that begin after the law is enacted.

What it means for you#

• For plan sponsors and health insurers: the bill would ban referral payments from PBMs to brokers, consultants, advisors, or similar people.
• For PBMs and intermediaries: the bill would bar paying compensation tied to referrals of plan or issuer business.
• For plan participants and beneficiaries: No publicly available information on direct, immediate effects for individual coverage or costs.

Expenses#

No publicly available information on government costs, savings, or financial impacts to plans, PBMs, brokers, or others in the bill text or metadata.

Proponents' View#

The bill's stated purpose is to prohibit kickbacks to pharmacy benefit managers by banning referral payments from PBMs to brokers, consultants, advisors, or similar intermediaries.

Opponents' View#

No publicly available information on opposition, counterarguments, or alternative proposals in the bill text or metadata.