Invite Legislators to Your Independent Pharmacy and Show Them Why PBM Reform Can’t Wait

August is a critical month for independent pharmacy advocacy. With US Senators and Representatives will be home until right after Labor Day, this gives pharmacy owners a prime opportunity to invite them for a firsthand look at the Medicare and Medicaid challenges you face daily.

Now is the time to show, not just tell, lawmakers why they need to pass as soon as they return to Washington the following bipartisan PBM and Medicaid/Medicare reforms – Protecting Pharmacies in Medicaid Act (S. 927), Patients Before Middlemen Act (S. 882), and PBM Reform Act of 2025 (H.R. 4317).

The Senate Medicaid & Medicare Reform Bill would:

• Medicaid managed care payment reform – S. 927 (Welch [D-VT]/Marshall [R-KS]/Warner [D-VA/Cassidy [R-LA]) through enhanced transparency and a ban on spread pricing by reimbursing pharmacies at a rate equal to the national average drug acquisition cost (NADAC) plus the state’s fee-for-service dispensing fee. This would also save taxpayers nearly $3 billion.
• Medicare D Contract reforms – S. 882 (Blackburn [R-TN]/Hassan [D-NH]/Lankford [R-OK]/Warner [D-VA]/Marshall [R-KS]/Welch [D-VT]/Cortez Masto [D-NV]/Cassidy [R-LA]) require CMS to define & enforce reasonable & relevant contract terms in Part D, including terms related to reimbursements, and establish a mechanism for pharmacies to report violations.

The House PBM Reform Act – H.R. 4317 (Carter [R-GA]/ Dingell [D-MI]/Murphy [R-NC]/Arrington [R-TX]/Harshbarger [R-TN]/Gonzalez [D-TX]/Allen [R-GA)/Krishnamoorthi [D-IL]/Rose [R-TN]/Tran [D-CA]/Malliotakis [(R-NY] would:

• Ban “spread pricing” in Medicaid and move to a transparent system that ensures pharmacies are fairly and adequately reimbursed for serving Medicaid beneficiaries.
• Establish new requirements for PBMs under Medicare Part D, including a policy to delink PBM compensation from the cost of medications and increase transparency.
• Promote transparency for both employers and patients in their prescription drug plans, with semi-annual reporting on drug spending, rebates, and formulary determinations.
• Require Centers for Medicare and Medicaid Services (CMS) to define and enforce “reasonable and relevant” contract terms in Medicare Part D pharmacy contracts and enforce oversight on reported violations.

A pharmacy tour makes an impact. When legislators see how DIR fees, below-cost reimbursements, and PBM clawbacks threaten patient access, they become stronger allies in the fight for reform. If you don’t see your Senator or Representative listed as a sponsor or co-sponsor, ask them to sign on to this essential legislation.

Below, we’ll cover:

• How to invite a legislator to your pharmacy (with a sample email)
• A sample agenda for the visit
• Key talking points on pending legislation

Let’s make sure Congress hears our voices before they return to session in September.

Legislators vote on pharmacy issues every year, but few understand:

• The crushing impact of PBMs’ DIR fees on small pharmacies
• How Medicaid under-reimbursement forces closures
• Why Medicare Part D reform is essential for seniors’ access

A 15–30-minute tour can change that. When they meet your team, hear from patients, and see your operations, abstract policy becomes real.

August is your best chance. Let’s make it count.

Sample Email:

1. PBMs Are Hurting Independent Pharmacies & Patients

• “PBMs take $9 billion yearly in DIR fees—often clawed back 6 months later.”
• “Reimbursements are below cost, forcing pharmacies to reject Medicaid/Medicare patients.”
• “Three PBMs control 80% of the market, squeezing small pharmacies out.”
• Ask your Senators & Representative if they are willing to sign on as a co-sponsor to these pieces of legislation

2. Bipartisan Fixes Are Ready—But Need Support

3. The Time to Act Is Now

• “These bills could move in September, and your support is critical.”
• “Will you cosponsor/advance these reforms?”

1. Send the invite email today (use our template above).
2. Prepare your talking points (highlight DIR fees, patient stories).
3. Follow up with staff if you don’t hear back.