The U.S. Capitol rotunda. Photo: Diego M. Radzinschi/ALM
A Republican and a Democrat are bringing back a pharmacy benefit manager reporting bill that nearly became law during the 118th Congress.
Rep. Erin Houchin, R-Ind., and Rep. Joe Courtney, D-Conn., introduced a version of the Hidden Fees Disclosure Act bill for the 119th Congress Tuesday.
Recommended For You
The text of the new version was not available at press time, but it's similar to the text of the earlier version, which would require a PBM serving a self-insured employer health plan to send the employer a report showing all compensation the PBM has received; detailed information about any rebate or discounts negotiated, including information about the amounts of rebates or discounts to be passed through to the employer or the plan participants; and information about the PBM-related compensation flowing to other firms providing services for the employer's plan.
Third-party administrators serving self-insured employer plans would also have to provide detailed reports on their activities.
TPAs would have to tell employers about rebates, discounts, fees coming in from and going to other service providers, and recoveries from service providers associated with overpayments, erroneous payments, incomplete payments, billing errors, fraud and other matters.
The House included the bill in the Lower Costs, More Transparency Act bill, a package that passed in the House by a 320-71 vote in December. The hidden fees bill and the rest of the package nearly became law as a large spending package in December, but it was eventually removed from the package after Elon Musk asked for congressional leaders to replace the original spending package with a much shorter package. Musk did not comment on the bills excluded from the spending package, and it's not known what he or President Donald Trump think about the PBM-related provisions that were left out.
Related: New 'must pass' House package includes employer plan PBM section
PBMs help insurers, self-insured employer health plans and other payers manage prescription drug benefits.
PBMs contend that they are attracting criticism because of their success at holding down prescription drug prices and pharmacies' and wholesale distributors' profit margins.
PBMs' critics contend that a handful of big PBMs control too much of the market, operate in ways that weaken competition and keep too much of the discounts that they negotiate.
Houchin said the new hidden fees bill will help by making patients and policymakers aware of the true cost of prescriptions.
"Americans should never be blindsided by hidden costs in their health care," Houchin said.
The bill could have a good chance to move forward in the House.
Both Sen. Bill Cassidy, R-La., chairman of the Senate Health, Education, Labor and Pensions Committee and Rep. Brett Guthrie, R-Ky., chairman of the House Energy and Commerce Committee, have expressed support for passing PBM legislation.
© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
