Congressman Gonzalez Introduces Bipartisan Bill to Protect South Texas Patients and Pharmacies from PBM Middlemen

July 17, 2025 Press Release WASHINGTON, D.C. – Today, Congressman
Vicente Gonzalez (TX-34) announced the
introduction of H.R. 4317, the PBM Reform Act, a piece of bipartisan
legislation which protects South Texas patients and pharmacies from the harmful
and anticompetitive business practices of pharmacy benefit managers (PBM).
Congressman Gonzalez introduced this bill alongside Republican Congressman Earl
L. “Buddy” Carter (GA-01) and 10 other members of Congress (full list below). The
PBM Reform Act would ban “spread pricing” in Medicaid and move to a transparent
system that ensures pharmacies are fairly and adequately reimbursed for serving
Medicaid beneficiaries. The bill would also promote transparency for both
employers and patients in their prescription drug plans and lastly require the
Centers for Medicare and Medicaid Services (CMS) to define and enforce
"reasonable and relevant" contract terms in Medicare Part D pharmacy
contracts and enforce oversight on reported violations. “Pharmacy
Benefit Managers line their pockets and drive up the cost of life saving drugs
at the expense of South Texans and the community pharmacies they depend on —
this is shameful, dangerous, and must be stopped,” said Congressman
Gonzalez. “I’m proud to introduce this bipartisan legislation with
Congressman Buddy Carter that puts patients first, increases price
transparency, and holds PBMs accountable.” “It’s
time to bust up the PBM monopoly, which has been stealing hope and health from
patients for decades. As a pharmacist, I’ve seen how PBMs abuse patients
firsthand, and believe that the cure to this infectious disease is
transparency, competition, and accountability, which is exactly what our
bipartisan package provides,” said Congressman Buddy Carter . The
full list of original co-sponsors include: Congresswoman Debbie Dingell
(MI-12), Congressman Greg Murphy (NC-03), Congresswoman Deborah Ross (NC-02),
Congressman Jodey Arrington (TX-19), Congresswoman Diana Harshbarger (TN-01),
Congressman Rick Allen (GA-12), Congressman Raja Krishnamoorthi (IL-08),
Congressman John Rose (TN-06), Congressman Derek Tran (CA-45), and
Congresswoman Nicole Malliotakis (NY-11). Background Pharmacy
benefit managers were created as middlemen to reduce administrative costs for
insurers, validate a patient’s eligibility, administer plan benefits, and
negotiate costs between pharmacies and health plans. Over time, PBMs have been
allowed to operate virtually unchecked as they consolidated to where three
companies now control 80% of the prescription drug market. Vertical
integration and a lack of transparency have led to pharmacy closures and higher
costs for patients across the country. Read
the full text here . ### Issues : Health Care