From 2029 contract terms must be reasonable and relevant
Making further consolidated appropriations for the fiscal year ending September 30, 2026, and for other purposes, section 6223, Sec. 6223.
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From 2029 contract terms must be reasonable and relevant
The document says “shall”Who acts: prescription drug plan sponsors, Secretary of Health and Human ServicesHow: statuteSec. 6223 in the PDF
What the document says
“Notwithstanding any other provision of law, for plan years beginning on or after January 1, 2029, in accordance with clause (i), contract terms and conditions offered by such PDP sponsor shall be reasonable and relevant according to standards established by the Secretary under subclause (II).”
For plan years beginning on or after January 1, 2029, the terms and conditions a sponsor offers must be reasonable and relevant according to standards the Secretary establishes. The Secretary must set those standards no later than the first Monday in April of 2028.
What the document actually says
“Notwithstanding any other provision of law, for plan years beginning on or after January 1, 2029, in accordance with clause (i), contract terms and conditions offered by such PDP sponsor shall be reasonable and relevant according to standards established by the Secretary under subclause (II).”
That sentence, in plain words
For plan years that start on or after January 1, 2029, the terms a plan offers must be fair and on point. The health chief sets the test for that.
What this is about
A plan could set terms so hard that no small pharmacy could meet them. That would undo the rule above. This puts a limit on the terms.
No action is recorded against this proposal. That is not evidence that none has been taken, and nobody has yet read it against the record. See what the tracker does not yet cover.
Consolidated Appropriations Act, 2026, Public Law 119-75, sec. 6223, 140 Stat. 664 (2026). https://www.govinfo.gov/content/pkg/PLAW-119publ75/html/PLAW-119publ75.htm
This page
“From 2029 contract terms must be reasonable and relevant,” Consolidated Appropriations Act, 2026, section 6223, Sec. 6223. Read the Mandate, https://readthemandate.org/consolidated-appropriations-act-2026/proposal/sec6223-reasonable-and-relevant-terms/ (retrieved August 26, 2026).
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