Community Pharmacy Applauds House Passage of PBM Reform Provisions in Budget Bill

ALEXANDRIA, Va. (May 22, 2025) – The National Community Pharmacists Association issued the following statement from CEO B. Douglas Hoey, pharmacist, MBA, after the House of Representatives today passed a budget reconciliation bill that includes language that would eliminate pharmacy benefit manager spread pricing and require transparent and fair reimbursement (Medicaid fee-for-service-rate) in all state Medicaid managed care programs: 

“While doing nothing to reduce the cost of drugs for Medicaid beneficiaries, spread pricing has been costing federal and state taxpayers hundreds of millions of dollars every year. Through low and underwater reimbursements, PBMs have been systematically squeezing local pharmacies and helping drive them out of business. It’s egregious. Moving to a fairer pharmacy reimbursement system that ends spread pricing and requires transparent, predictable reimbursements to pharmacies is a step in the right direction. We urge the Senate to swiftly pass these provisions and President Trump to sign them into law.”

Spread pricing is what happens when PBMs charge insurance plans like Medicaid one price for prescription medications, reimburse pharmacies that dispense them a much lower price, and then keep a big chunk of the difference (the spread) for themselves. For years, NCPA has led the way in pushing Congress and the executive branch to ban this practice and to pay pharmacies in a simple, predictable format that covers their costs to dispense prescription medications. The reconciliation bill now heads to the Senate for further consideration. NCPA will continue strongly advocating for these Medicaid policies and will also keep fighting for Medicare Part D contract reform to be included in other legislation moving this year.