The Pharmacy Benefit Manager Transparency Act of 2025 seeks to curb unfair and deceptive acts or practices by pharmacy benefit managers (PBMs) concerning prescription drug services. Specifically, it prohibits PBMs from engaging in spread pricing , where they charge health plans more for a drug than they reimburse pharmacies, and from arbitrarily reducing or clawing back payments to pharmacies. The bill also prevents PBMs from increasing fees or lowering reimbursements to pharmacies to offset changes mandated by the Federal Government. PBMs can avoid violating these prohibitions if they pass 100 percent of any price concessions, such as rebates or discounts, to health plans or payers. Additionally, they must provide full and complete disclosure of the cost, price, and reimbursement of prescription drugs to health plans, payers, and pharmacies. This includes detailing all fees, markups, discounts, and the aggregate amount of remuneration received from drug manufacturers. The legislation mandates significant transparency , requiring PBMs to report annually to the Federal Trade Commission (FTC) and HHS on aggregate payment differences, fees charged to pharmacies, and explanations for formulary tier changes. The FTC will also submit annual reports to Congress, summarizing enforcement actions, analyzing market impacts, and providing policy recommendations. Additionally, the Government Accountability Office (GAO) will conduct a study on PBM practices and competition. To ensure accountability, the Act includes robust whistleblower protections , safeguarding individuals who report potential violations from retaliation. Enforcement of the Act falls primarily to the Federal Trade Commission (FTC) , which can treat violations as unfair or deceptive practices under existing law and impose civil penalties of up to $1,000,000. State attorneys general are also empowered to bring civil actions to protect their residents, with provisions for FTC intervention. Furthermore, the bill ensures the protection of personal health information during any required disclosures, prohibiting the identification of patients or providers. Importantly, this Act does not preempt or displace existing state laws, rules, or regulations related to pharmacy benefit management. It defines key terms such as "pharmacy benefit manager" and "pharmacy benefit management services" to clarify its scope.