The Labor Department’s Employee Benefits Security Administration proposed regulation Jan. 29 that would require pharmacy benefit managers to disclose their compensation with self-insured group health plans.
Under the rule, PBMs would have to share information on their rebates and other manufacturer payments, compensation when plan prices exceed pharmacy reimbursement, and recouped pharmacy payments. Plan fiduciaries would also be able to audit PBM disclosures.
The proposal is accepting comments for 60 days, starting Jan. 30.
In recent years, PBMs have been subject to federal scrutiny. In 2022, the Federal Trade Commission launched an inquiry into the six largest PBMs. The commission’s initial report in July 2024 highlighted how PBMs are capable of hiking drug costs.
A lawsuit followed in September 2024, targeting CVS Caremark, Optum Rx and Express Scripts for allegedly inflating insulin prices. The PBMs filed their own lawsuit in response. The FTC eventually paused its case in April 2025 due to insufficient participating commissioners before lifting the motion to stay, which was met with PBM resistance.
Most recently, the FTC withdrew the matter from adjudication for Cigna’s Express Scripts and paused the case for 14 days to allow settlement discussions with the other respondents.
Going into 2026, PBM reforms have been picking up steam. The House passed elements of Republican Rep. Earl “Buddy” Carter’s PBM Reform Act under the Consolidated Appropriations Act. Several pharmacy groups have backed the efforts.
