Patients Choice in Specialty Pharmacy Act
The source supplies the latest action, but no lifecycle stage.
Latest action (24 Sep 2026): Referred to the House Committee on Energy and Commerce.
What this bill does
H.R. 10549, the Patients Choice in Specialty Pharmacy Act, would amend the Public Health Service Act. It aims to prevent certain group health plans and health insurance issuers from directing individuals to use specific specialty pharmacies, often referred to as "affiliated specialty pharmacies." The bill would prohibit these plans and issuers from imposing higher costs, offering financial incentives, or creating administrative burdens for individuals who choose to get specialty drugs from pharmacies not affiliated with their plan or insurance. It would also prevent these plans and issuers from excluding qualified specialty pharmacies from their networks, unless for specific reasons like fraud, abuse, or an imminent risk of patient harm.
This legislation would affect individuals enrolled in group health plans (excluding self-insured ones) and health insurance coverage who require specialty drugs. It would also impact specialty pharmacies by requiring plans and issuers to contract with any qualified specialty pharmacy willing to accept network terms and reimbursement rates, unless the pharmacy has a history of fraud or abuse. The bill defines specialty pharmacies as those dispensing drugs for complex conditions that require special handling or patient support.
As of its introduction on September 24, 2026, H.R. 10549 has been referred to the House Committee on Energy and Commerce. For the bill to become law, it would need to pass the House of Representatives, then be approved by the Senate, and finally be signed by the President. The proposed changes would take effect for plan years beginning on or after January 1, 2029, if enacted.
Plain-English summary generated by Bill100 AI from the official record. Always verify against the source below.
Timeline
24 Sep 2026
Referred to the House Committee on Energy and Commerce.
Common questions
- What does H.R. 10549 do?
- H.R. 10549, the Patients Choice in Specialty Pharmacy Act, would amend the Public Health Service Act. It aims to prevent certain group health plans and health insurance issuers from directing individuals to use specific specialty pharmacies, often referred to as "affiliated specialty pharmacies." The bill would prohibit these plans and issuers from imposing higher costs, offering financial incentives, or creating administrative burdens for individuals who choose to get specialty drugs from pharmacies not affiliated with their plan or insurance. It would also prevent these plans and issuers from excluding qualified specialty pharmacies from their networks, unless for specific reasons like fraud, abuse, or an imminent risk of patient harm. This legislation would affect individuals enrolled in group health plans (excluding self-insured ones) and health insurance coverage who require specialty drugs. It would also impact specialty pharmacies by requiring plans and issuers to contract with any qualified specialty pharmacy willing to accept network terms and reimbursement rates, unless the pharmacy has a history of fraud or abuse. The bill defines specialty pharmacies as those dispensing drugs for complex conditions that require special handling or patient support. As of its introduction on September 24, 2026, H.R. 10549 has been referred to the House Committee on Energy and Commerce. For the bill to become law, it would need to pass the House of Representatives, then be approved by the Senate, and finally be signed by the President. The proposed changes would take effect for plan years beginning on or after January 1, 2029, if enacted.
- Has H.R. 10549 become law?
- The source does not supply a confirmed lifecycle stage for H.R. 10549. Check the latest action and official source below.
- Who sponsored H.R. 10549?
- H.R. 10549 was sponsored by Rep. Dunn, Neal P. [R-FL-2] (R-FL), with 1 cosponsor.
- What's the latest action on H.R. 10549?
- Referred to the House Committee on Energy and Commerce. (24 Sep 2026).
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