New Bill: Representative Jake Auchincloss introduces H.R. 6609: Pharmacists Fight Back in Medicare and Medicaid Act

By: Quiver LegislationRadar

Posted: 7 hours ago / Jan. 3, 2026 4:07 p.m. UTC

We have received text from H.R. 6609: Pharmacists Fight Back in Medicare and Medicaid Act. This bill was received on 2025-12-11, and currently has 22 cosponsors.

Here is a short summary of the bill:

This bill, titled the “Pharmacists Fight Back in Medicare and Medicaid Act,” proposes amendments to the Social Security Act, specifically targeting the regulation of pharmacy benefit managers (PBMs) in Medicare and Medicaid programs. Here’s a breakdown of the key provisions:

1. Requirements for Pharmacy Benefit Managers (PBMs) in Medicare

The bill introduces new requirements for Medicare prescription drug plans beginning in 2027:

• 
  Pharmacy Payment Compliance:
  
  PBMs must adhere to specific payment standards for pharmacies, ensuring they are reimbursed based on the national average drug acquisition cost or wholesale acquisition cost, plus a fixed percentage or a cap.
• 
  Dispensing Fees:
  
  PBMs must pay pharmacies a dispensing fee equivalent to what is established under state Medicaid plans, without requiring patients to cover this additional cost.
• 
  Prohibition of Steering:
  
  PBMs are prohibited from directing patients to specific pharmacies, particularly those affiliated with the PBM.
• 
  Rebate Pass-Through:
  
  If a PBM receives manufacturer rebates, these must be applied at the point of sale to reduce the patient’s coinsurance or copayment.
• 
  Annual Reporting:
  
  PBMs must submit annual reports to the Secretary confirming compliance with these requirements.

2. Medicaid Provisions

Similar rules are proposed for Medicaid, which require that:

• 
  Payment Standards:
  
  Entities covering outpatient drugs must ensure payments match the drug cost standards established in Medicare, including a dispensing fee and any applicable rebates to the state.
• 
  Steering Restrictions:
  
  PBMs and relevant entities are similarly barred from steering patients to specific pharmacies.

3. Transparency Enhancements

The bill aims to improve transparency within the Medicaid program by revising reporting and compliance standards so that pharmacies must report acquisition prices and other financial data as part of state surveys. Additionally:

• 
  Public Access to Pricing:
  
  States must make information on drug acquisition prices publicly available.

4. Penalties for Non-Compliance

To enforce these standards, the bill establishes criminal and civil penalties for PBMs that do not comply, including the possibility of fines and imprisonment for serious violations. Specific violations that could lead to penalties include:

• Failure to comply with payment requirements.
• Engaging in steering practices.
• Not adhering to rebate pass-through mandates.

5. Effective Dates

The majority of the provisions are set to come into effect starting January 1, 2027, allowing time for stakeholders to adapt to the new regulations.

Relevant Companies

• CVS

  : Acts as a pharmacy benefit manager and may face compliance requirements and operational changes due to the act.

• ANTM

  : As a managed care organization, it will need to align its practices with the new PBM regulations in Medicare and Medicaid.

• ELAN

  : May also be impacted due to its involvement in pharmaceutical management services.

Representative Jake Auchincloss Bill Proposals

Here are some bills which have recently been proposed by Representative Jake Auchincloss:

• H.R.6837: To amend the Employee Retirement Income Security Act of 1974 to ensure that pharmacy benefit managers are considered fiduciaries, and for other purposes.
• H.R.6610: Pharmacists Fight Back [in Federal Employee Health Benefit Plans Act]
• H.R.6609: Pharmacists Fight Back in Medicare and Medicaid Act
• H.R.6335: Education Not Endless Scrolling Act
• H.R.6334: Deepfake Liability Act
• H.R.6333: Parents Over Platforms Act

You can track bills proposed by Representative Jake Auchincloss on Quiver Quantitative’s politician page for Auchincloss.

Representative Jake Auchincloss Net Worth

Quiver Quantitative estimates that Representative Jake Auchincloss is worth $4.0M, as of January 3rd, 2026. This is the 188th highest net worth in Congress, per our live estimates.

Auchincloss has approximately $2.1M invested in publicly traded assets which Quiver is able to track live.

You can track Representative Jake Auchincloss’s net worth on Quiver Quantitative’s politician page for Auchincloss.

Representative Jake Auchincloss Stock Trading

We have data on up to $350.0K of trades from Representative Jake Auchincloss, which we parsed from STOCK Act filings. Some of the largest trades include:

• A August 18th, 2025 sale of up to $50K of $STT. The stock has risen 14.82% since then.

You can track Representative Jake Auchincloss’s stock trading on Quiver Quantitative’s politician page for Auchincloss.

This article is not financial advice. See Quiver Quantitative’s disclaimers for more information.