PUTT BLOG | PFBA Introduction Caps a Winning Year in Our Fight for PBM Reform

“We have accomplished a feat so rarely seen in Washington. We’ve brought the most extreme democrats and republicans together to agree and work towards the same goal.” 

– Dr. Nikki Adams-Bryant, Adams Family Pharmacy, Preston GA

On Thursday, December 11th, 55 pharmacy professionals from 22 states and the District of Columbia joined Representatives Jake Auchincloss (D-MA), Diana Harshbarger (R-TN), Sanford Bishop (D-GA), Rashida Tlaib (D-MI), and House Oversight Chair James Comer (R-KY) for a news conference announcing the reintroduction of the Pharmacists Fight Back Act (PFBA). Now split into companion bills, PFBA H.R. 6609 has been assigned to House Energy and Commerce and Ways and Means committees. PFBA-2 H.R. 6610 has been referred to the House Committee on Oversight and Government Reform.  

Thank you to everyone who heeded the call to come to DC in support of PFBA. At a time when the Administration seeks solutions and is willing to move quickly to implement them, it was critical we matched that energy - and we did! By end of day December 11, HR 6609 had 21 cosponsors and HR 6610 had 18, a direct result of the 37 meetings following the news conference, including with Speaker Johnson and E&C Subcommittee on Health Chair Morgan Griffith.

The re-introduction of PFBA caps a year of exciting and controversial reform efforts that took off at the state level, and while there are many, many states to acknowledge and congratulate, in the interest of time and brevity we highlight 2 distinct, but important state victories and 2 other PUTT efforts that accelerated interest in immediate PBM oversight:

Patients Before Monopolies in Arkansas

In April, Arkansas enacted Act 624, groundbreaking legislation effectively banning PBM-owned pharmacies from operating within the state while the PBM is also operating and administering benefits to enrolled Arkansans. Said simply, a PBM cannot administer pharmacy benefits and use its owned/affiliated pharmacies to fill plan prescriptions. 

Governor Sarah Huckabee Sanders addressed the issue of PBM ownership as a conflict of interest that harms patients and undermines community pharmacies in a New York Times op-ed published weeks after the law was enacted. A preliminary injunction has since been placed on Act 624, which was set to take effect January 1, 2026. The Arkansas Board of Pharmacy is appealing the injunction.

Texas Holds ‘Em

Laws can be passed but laws can also be overturned. When HB 139 was introduced in Texas this year, pharmacy owners and advocates, including PUTT, the Texas Pharmacy Association, American Pharmacies and the Texas Medical Association, joined forces in a united front to aggressively oppose the bill. If passed, HB 139, would have created the attractive-sounding “Employers Choice of Benefits” while overturning more than a decade of critical reforms necessary to keep a fair and level playing field for pharmacies and medical providers: Payment parity, patient steering, prompt payment, surprise billing, and network adequacy were among the many patient and provider protections that would have been exempted under the new law. HB 139 was withdrawn by its sponsor mere minutes before the legislature’s midnight adjournment, resulting in a decisive win.

The Audit Tricare Campaign: Because Our Military and Our Taxpayers Deserve Better

One of PUTT's most impactful initiatives in 2025 was the "Audit Tricare" campaign (AuditTricare.org), which captured national attention and elevated concerns about PBM pricing practices for military families and veterans. 

The campaign continues to generate significant momentum on Capitol Hill, and has resulted in multiple meetings with members of Congress as well as staff from both the House and Senate Judiciary Committees. The campaign demonstrates that PBM reform is about more than protecting community pharmacies—it's about safeguarding patient access among those who put their lives on the line for our country.

Thought PBM Overbilling in Medicaid was Over? Meet Virginia 

Between 2017 and 2023, the Commonwealth of Virginia overpaid its Medicaid managed care plans by an estimated $10.86 billion compared to the national average. Additionally, Virginia missed out on an estimated $880 million savings in 2023 alone by not utilizing NADAC plus the state’s Medicaid professional dispensing fees. These were just some of the findings in the first half of a 2-part report analyzed and authored by PUTT Board member Jeremy Counts in his capacity as Chief Analyst at Strategic Directions Rx. At a time when everyone assumed gross overpayment of prescription drug claims in Medicaid managed care was largely over, “Diagnosing Medicaid Drug Overspend in the Commonwealth” was the bombshell no one saw coming.

Looking Ahead to 2026

As we close out the calendar year, the momentum is palpable. PUTT members are energized and ready to introduce new, better and more effective legislation in their states, informed by the successes of Arkansas, Texas, Virginia, Minnesota and many other states who championed reform in 2025. That PFBA has champions on both sides of the aisle is further evidence that change is happening. But most importantly, the pharmacy community is united and attracting advocates from other healthcare professions. And we’re ready to stand by our fellow providers as they have stood by us.

To every PUTT member who made calls, sent emails, attended lobby days, shared your stories, and refused to give up: Thank You. Your efforts are making a difference. The wins in 2025 belong to you, and they set the stage for even greater achievements ahead.

Here's to a year of persistence, progress, and evidence that truth can prevail.

We’ll see you in 2026, ready to continue fighting back!

Monique Whitney

Executive Director