H.R. 7895House119th Congress (2025-2027)In Committee

PBM Kickback Prohibition Act

Introduced March 12, 2026

AI-Generated Summary

Updated April 2, 2026 at 5:51 AM UTC

The PBM Kickback Prohibition Act amends the Employee Retirement Income Security Act to bar pharmacy benefit managers (PBMs) from paying any compensation—directly or indirectly—to brokers, consultants, advisors, or other individuals in exchange for referrals of business from covered retirement plans or health‑insurance issuers. The rule applies to any contract or arrangement between a covered plan and a PBM and takes effect for plan years that begin after the law is enacted.

Key Provisions

  • Adds a new prohibition that PBMs cannot pay any amount to brokerage firms, brokers, consultants, advisors, or other individuals for referring a covered plan’s or health‑insurance issuer’s business to the PBM.
  • The amendment applies to contracts or arrangements for pharmacy benefit management services involving covered plans.
  • The rule becomes effective for plan years beginning after the act’s enactment date.

Legislative Activity

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5 earlier actions
HouseCalendars Latest Action

Placed on the Union Calendar, Calendar No. 634.

July 2, 2026

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HouseIntro Referral

Introduced in House

March 12, 2026

HouseIntro Referral

Referred to the House Committee on Education and Workforce.

March 12, 2026

HouseCommittee

Committee Consideration and Mark-up Session Held

May 21, 2026

HouseCommittee

Ordered to be Reported (Amended) by the Yeas and Nays: 34 - 0.

May 21, 2026

HouseCommittee

Reported (Amended) by the Committee on Education and Workforce. H. Rept. 119-729.

July 2, 2026

HouseCalendars

Placed on the Union Calendar, Calendar No. 634.

July 2, 2026

Bill Text

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Reported in HouseIssued July 2, 2026

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Union Calendar No. 634

119th CONGRESS

2d Session

H. R. 7895

[Report No. 119–729]

IN THE HOUSE OF REPRESENTATIVES

March 12, 2026

Mr. Allen introduced the following bill; which was referred to the Committee on Education and Workforce

July 2, 2026

Reported with an amendment, committed to the Committee of the Whole House on the State of the Union, and ordered to be printed

Strike out all after the enacting clause and insert the part printed in italic

For text of introduced bill, see copy of bill as introduced on March 12, 2026


A BILL

To amend section 408 of the Employee Retirement Income Security Act of 1974 to prohibit kickbacks to pharmacy benefit managers.


1.

Short title

This Act may be cited as the PBM Kickback Prohibition Act.

2.

Prohibition on pharmacy benefit manager kickbacks

(a)

In general

Section 408(b)(2)(B) of the Employee Retirement Income Security Act (29 U.S.C. 1108(b)(2)(B)) is amended by adding at the end the following:

(xi)
(I)

In the case of a contract or arrangement between a covered plan and a covered service provider for pharmacy benefit management services, no amount of compensation (whether direct compensation or indirect compensation) may be paid by such service provider to any individual or entity for—

(aa)

the referral, recommendation, placement, retention, or renewal of, or access to, the business of the covered plan or the health insurance issuer offering health insurance coverage for the covered plan;

(bb)

inclusion in, participation in, or the design of—

(AA)

a request for proposal;

(BB)

a market check;

(CC)

an evaluation;

(DD)

the volume, value, or use of covered plan business; or

(EE)

any other contracting process.

(II)

For the purposes of this clause, the characterization of compensation shall be based on the economic substance and practical operation of the contract or arrangement, without regard to the characterization or labeling of the compensation by the covered service provider.

(III)

Any compensation paid by a covered service provider to a brokerage firm, broker, consultant, advisor, or related entity shall be presumed to be related to an activity described in item (aa) or (bb) of subclause (I) unless the parties demonstrate through contemporaneous written documentation that such compensation—

(aa)

reflects fair market value for bona fide services actually rendered; and

(bb)

is not related, directly or indirectly, to any activity described in such items.

.

(b)

Effective date

The amendment made by this section shall apply for plan years beginning after the date of enactment of this Act.

July 2, 2026

Reported with an amendment, committed to the Committee of the Whole House on the State of the Union, and ordered to be printed