Congresswoman Nicole Malliotakis (NY-11) announced that the House has passed the bipartisan Consolidated Appropriations Act of 2026, which includes reforms aimed at regulating pharmacy benefit managers (PBMs) and reducing prescription drug costs. The bill is the final appropriations package to fund the federal government for Fiscal Year 2026.
Malliotakis has consistently advocated for PBM reform since taking office. She has hosted roundtables, held press conferences, and authored an op-ed to highlight the need for changes in how PBMs operate. According to Malliotakis, these reforms are expected to lower drug prices, particularly for seniors who rely on Medicare for their medication coverage.
The new provisions will remove incentives that tie PBM profits to drug prices in Medicare and instead require flat fees. They also mandate that all rebates and discounts from drug manufacturers be passed directly to employers and their workers. The legislation seeks to strengthen patient access to local and independent pharmacies and increase transparency in drug pricing decisions.
“Today, the House took bipartisan action to responsibly fund the remaining agencies of the federal government and crack down on the exploitative pricing tactics of pharmacy benefit managers—taking a major step toward real reform of a system that has driven prescription drug prices to record levels,” said Rep. Nicole Malliotakis. “PBMs’ exploitative practices have left patients with skyrocketing prescription drug costs and have driven many independently owned ‘Mom & Pop’ pharmacies out of business throughout the country. Today, Congress has taken the necessary action to ensure these predatory practices through insurance companies are finally reined in so we can continue our work to drive down costs for patients.”
The reforms included in the appropriations act contain several key sections:
– Section 6224 restructures PBM compensation in Medicare Part D by prohibiting payment arrangements tied to drug list prices and introducing flat fees or other neutral arrangements.
– Section 6702 requires PBMs to remit all manufacturer rebates and concessions directly to group health plan sponsors without retaining any portion.
– Section 6223 reinforces access principles by ensuring that any willing pharmacy can participate in Medicare Part D networks under reasonable terms.
– Section 6701 mandates detailed semi-annual reporting from PBMs about rebates, fees, discounts, spread pricing arrangements, and formulary decisions.
PBMs were initially created to manage administrative costs and negotiate lower drug prices but now three companies control about 80 percent of the market due to consolidation. Critics say this concentration has led to less oversight, higher costs for patients nationwide, and forced closures of independent pharmacies.
Nicole Malliotakis is currently serving as U.S. Representative for New York’s 11th district after replacing Max Rose in 2021. She previously served in the New York State Assembly from 2011 until her election to Congress. Born in New York City in 1980, she lives in Staten Island and holds degrees from Seton Hall University and Wagner College.
