H.R. 10133 — Fair Prescription Pricing Act of 2026

This section prohibits group health plans and health insurance issuers from imposing cost sharing (including deductibles, coinsurance, and copayments) for a covered outpatient drug dispensed by an in-network pharmacy that exceeds the nationwide average of consumer purchase prices for that drug over the prior year, as determined by the survey under section 1927(f)(1)(A)(i) of the Social Security Act. The limitation applies for plan years beginning on or after the date of enactment under the Public Health Service Act, Employee Retirement Income Security Act, and Internal Revenue Code, and requires plans to ensure pharmacy benefit managers comply.