Congressional 2026 Spending Bill Advances PBM Reforms in Medicare Part D
The 2026 appropriations bill for HHS mandates CMS to define clear, reasonable contract terms for pharmacies in Medicare Part D, curbing PBM predatory practices.12
Reforms include delinking PBM compensation from drug prices, enhanced transparency reporting, pharmacy network access standards, and penalties for violations.134
Bipartisan support from lawmakers like Rep. Buddy Carter, Sens. Mike Crapo and Ron Wyden; praised by NCPA and pharmacist groups as first major Part D update in 20 years.16
Bill bans Medicaid spread pricing, requires commercial rebate passthroughs, and allocates $188 million for implementation; awaits House and Senate passage.145
No explicit mention of rare pediatric voucher reauthorization in available sources; focus remains on PBM and pharmacy reforms.
Sources:
1. https://www.drugtopics.com/view/congressional-spending-bill-to-include-key-pbm-contracting-reform
2. https://www.economicliberties.us/press-release/pbm-reforms-in-house-funding-bill-come-years-too-late-now-congress-must-finish-the-job/
3. https://www.bipc.com/a-pivotal-moment-for-patients-and-independent-pharmacies-congress-acts-on-pbm-reform-with-bipartisan-legislation
4. https://www.hklaw.com/en/insights/publications/2026/01/holland-knight-health-dose-january-21-2026
5. https://www.statnews.com/2026/01/20/congress-budget-deal-health-care-policy-hhs-budget-increased/
6. https://ncpa.org/newsroom/news-releases/2026/01/21/pharmacist-and-pharmacy-organizations-commend-2026-spending-bill