DOL Issues Proposed Rule on Improving Transparency into PBM Fees

February 12, 2026

EGWP marketplace medicaid Medicare

Pursuant to President Trump’s Executive Order “Lowering Drug Prices by Once Again Putting Americans First,” the Department of Labor’s (DOL’s) Employee Benefits Security Administration (EBSA) issued a proposed rule that would require providers of PBM services and affiliated entities of brokerage and consulting services to disclose direct and indirect compensation to their self-funded ERISA fiduciary clients. The government funding legislation pending in Congress also includes PBM compensation disclosure requirements, which may overlap or conflict with these proposed regulations.

We are closely reviewing the proposed rule in parallel with the PBM-related disclosures moving through Congress. We will support development of written comments by the March 31 deadline as well as drive external advocacy with our trades, coalitions, and external partners to ensure any final regulation supports transparency while remaining workable for the employers, plans, and patients we serve.

Initiatives

Calls grow for Drug Patent reform

In a recent blog post, the Pharmaceutical Care Management Association (PCMA) highlighted increased attention to pharmaceutical companies’ abuse of drug patents. Last month, the Supreme Court unanimously ruled in favor of a generic drugmaker in a “skinny labeling” case, a victory for patients. Skinny labels allow generic and biosimilar competitors to launch products for non-patented indications, helping accelerate […]
read more >

August 11, 2026

EGWP marketplace medicaid Medicare

perspectives

AHIP calls for Bipartisan reform to address health care cost drivers

On July 23, AHIP President and CEO Mike Tuffin wrote an opinion piece in The New York Times saying, “common-sense bipartisan reforms are needed to promote competition in care delivery and prescription drugs, protect consumers from providers and drugmakers’ anticompetitive practices and transition away from the perverse incentives of fee-for-service medicine.” Tuffin notes that health […]
read more >

August 11, 2026

EGWP marketplace medicaid Medicare

Solutions

PCMA urges preserving patient access and flexibility in new fertility benefits rule

PCMA recently submitted comments to HHS, DOL, and the Treasury (the Departments) in response to the proposed rule establishing a new category of limited excepted benefits for fertility services. PCMA supports the Departments’ goal of expanding access to fertility care while encouraging employer innovation but urged several targeted refinements to ensure the framework is operationally […]
read more >

August 11, 2026

marketplace medicaid

You may also like