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

July 17, 2025

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.

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Issues:Health Care