H.R. 4409

119th CONGRESS 1st Session

To prohibit the common ownership pharmacy benefit managers and pharmacies that provide services under contracts with Federal health plans for Federal employees.

IN THE HOUSE OF REPRESENTATIVES · July 15, 2025 · Sponsor: Mr. Krishnamoorthi · Committee: Committee on Oversight and Government Reform

Table of contents

• H.R. 4409
  • SEC. 1. Short title
  • SEC. 2. Prohibitions relating to anticompetitive pharmacy ownership and contracts

SEC. 1. Short title

• This Act may be cited as the Fair Pharmacies for Federal Employees Act of 2025.

SEC. 2. Prohibitions relating to anticompetitive pharmacy ownership and contracts

• (a) Prohibition on pharmacy or pharmacy benefit manager ownership by entities providing insurance under Federal employee health plans
  • It shall be unlawful for the Office of Personnel Management to contract with a Federal employee health benefit qualified carrier who—
  • Prohibition on pharmacy or pharmacy benefit manager ownership by entities providing insurance under Federal employee health plans
    • directly or indirectly owns, operates, controls, or directs the operation of the whole or any part of a pharmacy; or
    • directly or indirectly owns, operates, or controls the whole or any part of a pharmacy benefit manager, or is directly or indirectly owned, operated, or has its operation directed by the whole or in any part by a pharmacy benefit manager.
• (b) Prohibition on pharmacy ownership by entities providing pharmacy benefit management services under Federal employee health plans
  • It shall be unlawful of the Office of Personnel Management or a Federal employee health benefit qualified carrier to contract or subcontract with a pharmacy benefit manager who directly or indirectly owns, operates, controls, or directs the operation of the whole or any part of a pharmacy.
• (c) Rule of construction
  • Nothing in this section shall be construed to limit the authority of the Federal Trade Commission, the Inspector General of the Department of Justice, the Department of Health and Human Services, or the attorney general of a State under any other provision of law.
• (d) Definitions
  • In this section:
    • The term health plan means a group insurance policy or contract, medical or hospital service agreement, membership or subscription contract, or similar group arrangement provided by a carrier for the purpose of providing, paying for, or reimbursing expenses for health services.
    • The term person has the meaning given the term in section 8 of the Sherman Act (). 15 U.S.C. 7
    • The term pharmacy benefit manager means any person, business, or other entity, such as a third-party administrator, regardless of whether such person, business, or entity identifies itself as a pharmacy benefit manager, that, either directly or indirectly through an intermediary (including an affiliate, subsidiary, or agent) or an arrangement with a third party—
    • The term means a voluntary association, corporation, partnership, or other nongovernmental organization which is lawfully engaged in providing, paying for, or reimbursing the cost of, health services under group insurance policies or contracts, medical or hospital service agreements, membership or subscription contracts, or similar group arrangements, in consideration of premiums or other periodic charges payable to the carrier, including a health benefits plan duly sponsored or underwritten by an employee organization and an association of organizations or other entities described in this paragraph sponsoring a health benefits plan. qualified carrier