Medicare enforces drug price negotiation with manufacturer rebates
H.R. 4299 — Protecting Patient Access to Cancer and Complex Therapies Act · Filed by Gregory Murphy (R-NC) · 55 cosponsors · Introduced Jul 7, 2025 · Referred to committee
Your members of Congress
Enter a ZIP to see where your representative and both senators stood on this bill.
Looked up on this device — your ZIP is never stored on our servers.
What it does
This bill amends Medicare's drug payment rules to require pharmaceutical manufacturers to pay rebates to Medicare when their drugs are subject to price negotiation under existing law. The rebate equals the difference between what Medicare would normally pay (ASP+6) and the negotiated maximum fair price (MFP+6), multiplied by the number of units dispensed. Patients' out-of-pocket costs are capped at 20% of the negotiated price rather than the higher standard price, and rebates flow into Medicare's trust fund.
Why we flagged it
The bill's core function is to operationalize existing price-negotiation authority by creating a rebate structure that enforces manufacturer compliance with negotiated prices and reduces beneficiary cost-sharing. It is not deregulation or a new negotiation power—it is a payment mechanism tied to existing law.
What the text implies
- The rebate mechanism applies only to 'selected drugs' already subject to price negotiation under Section 1192; the bill does not expand which drugs are negotiable, but it does create a financial enforcement tool that may increase manufacturer incentive to comply with negotiated prices or challenge them in court.
- Patient coinsurance is recalculated based on the lower MFP+6 price, which reduces out-of-pocket costs but also means beneficiaries do not see the full 'savings' from negotiation—the difference between ASP+6 and MFP+6 is split between the rebate (to Medicare) and lower coinsurance (to beneficiaries).
- The bill excludes MFP rebates from ASP calculation (Section 1847A(c)(3)), which prevents the rebate from inflating future ASP baselines and protects the negotiation mechanism from being undermined by its own success.
- Conforming amendments to ASC and OPP payment systems suggest the rebate structure will apply across multiple Medicare payment settings (Part B, ASC, OPP), creating a uniform enforcement mechanism but also increasing administrative complexity for manufacturers and CMS.
Section numbers refer to the bill text the analysis read — linked under Primary records below.
Who it affects
Ordinary Medicare beneficiaries pay lower out-of-pocket costs (20% of negotiated price vs. 20% of higher standard price) and Medicare's trust fund is strengthened by manufacturer rebates. The bill operationalizes existing price-negotiation authority by creating a financial mechanism that incentivizes compliance and protects beneficiary affordability.
Who stands to gain
- Medicare beneficiaries (lower out-of-pocket costs)
- Medicare trust fund (rebate deposits)
Named in the bill
Centers for Medicare & Medicaid Services (CMS), Pharmaceutical manufacturers, Medicare beneficiaries, Federal Supplementary Medical Insurance Trust Fund, Section 1847A (Part B payment rules), Section 1192 (selected drug definition), Section 1191 (price negotiation authority)
Where it stands
55 cosponsors: 38 Republicans, 17 Democrats.
- Jul 7, 2025 — Introduced · Congress.gov: “Introduced in House”
- Jul 7, 2025 — Referred to House Committee on Ways and Means and House Committee on Energy and Commerce · Congress.gov: “Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a…”
Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.
Money around this bill
38 lobbying clients named this bill on 48 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $17,074,300 in lobbying spend. A filing names 3 bills on average, so that figure is what each filing reported, not a share belonging to this bill.
More lobbying clients named this bill than 99% of bills with at least one filing.
Gregory Murphy, the sponsor, reported $1,068,698 in PAC receipts in the 2026 cycle. $42,000 of that came from 8 PACs tied to these lobbying clients.
- Bristol-myers Squibb Company — $3,160,000 on 1 filing
- Abbvie Inc. — $2,490,000 on 2 filings
- Amgen Inc — $2,440,000 on 1 filing
- Pfizer Inc. — $1,880,000 on 1 filing
- Mckesson Corporation & Affiliates U.S. Oncology and Rx Savings Solutions — $1,710,000 on 2 filings
Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.
How this was measured
Analysis — Quorum's AI read the bill text published by Congress.gov (9,838 characters) on Jun 3, 2026. Section numbers in the findings refer to that text, linked below; transparency and hidden-provision scores are compared against the median of 16,222 analysed bills.
Status and sponsors — Congress.gov's bill record — actions, committee referrals and cosponsors — loaded nightly. The timeline shows status changes, not every procedural action.
Money — Senate Lobbying Disclosure Act filings whose specific-issue field names this bill for quarters ending Dec 2025 to Jun 2026. A filing's amount is reported whole beside the median number of bills a filing names; it is never divided across them. PAC receipts are FEC-reported contributions to the sponsor's candidate committee in the 2026 cycle.
As of — lobbying records through Jul 20, 2026 · page rendered 2026-10-20.
“Medicare enforces drug price negotiation with manufacturer rebates” QuorumCivic. https://share.quorumcivic.app/bill/119/hr4299 Report an error
The week in bills
One email, Sunday: what Congress passed, what it changed, and who paid.
One link arrives to confirm the address. It is used for this email and nothing else, and every issue carries an unsubscribe link.