HR 5197

Summary

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.

Bill status

Status

In committee

Sponsor

Rep. Nicole Malliotakis [R-NY-11]

Cosponsors

0

Policy area

Health

Introduced

2025-09-08

Latest action

2025-09-08: 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.

Committee referrals

• Ways and Means Committee: House · Referred To · 2025-09-08
• Energy and Commerce Committee: House · Referred To · 2025-09-08

Recent actions

• 2025-09-08: 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.
• 2025-09-08: 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.
• 2025-09-08: Introduced in House
• 2025-09-08: Introduced in House