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Protect Beneficiaries from Middlemen Act

This bill limits cost-sharing for covered drugs under the Medicare prescription drug benefit and Medicare Advantage.

Specifically, for costs above the deductible but below the annual out-of-pocket threshold, the bill limits cost-sharing to the average net price of the drug (i.e., the average amount paid less any rebates) or the cash price (i.e., the price charged to an individual without insurance), whichever is lower.

The Government Accountability Office must report on the bill's implementation.

House floor actions Actions

IntroReferral

Sep. 08
2025

Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.

Library of Congress Actions

IntroReferral
Sep. 08 2025	Introduced in House Introduced in House

House bill HR5197-119

Protect Beneficiaries from Middlemen Act

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