Congress mandates healthcare pricing transparency—PBMs must disclose rebates, patients get itemized
H.R. 9117 — CHECK Act of 2026 · Filed by Nicholas Langworthy (R-NY) · Introduced Jun 3, 2026 · 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
The CHECK Act requires health plans and their service providers (including pharmacy benefit managers, third-party administrators, and networks) to disclose detailed pricing, fee schedules, rebates, and payment data to group health plans quarterly at no cost, and mandates that health plans provide patients with clear, itemized explanations of benefits within 45 days of a claim request. It also requires healthcare providers to furnish itemized bills within 30 days of final payment, with plain-language descriptions and billing codes, and prohibits collection actions unless the provider complied with these requirements or documented medical necessity for charges exceeding good-faith estimates.
Why we flagged it
The bill's core mechanism is mandatory disclosure of pricing, rebates, and payment data to health plans and patients, coupled with itemized billing requirements and enforcement penalties. It is fundamentally a transparency and accountability measure, not a subsidy, carve-out, or deregulation.
What the text implies
- Pharmacy benefit managers and third-party administrators face significant operational burden and cost to extract, format, and transmit detailed rebate and fee data quarterly; this may accelerate consolidation or shift costs to plan sponsors and ultimately premiums.
- The 45-day explanation-of-benefits deadline and 30-day itemized-bill requirement create new compliance infrastructure for providers and plans; smaller providers may face disproportionate cost to implement systems.
The full analysis lists 5 implications of this text.
Who stands to gain
health plans (gain cost-control data and leverage in negotiations); self-funded employers (gain visibility into plan costs and service-provider fees); patients (gain itemized billing and explanation-of-benefits clarity)