H.R. 5197: Protect Beneficiaries from Middlemen Act
Latest action, September 8, 2025: Introduced in House
Official 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.