DOL Rule Forces Pharmacy Benefit Managers to Disclose Fees
A new federal rule requires PBMs to reveal hidden fees to employers, potentially cutting prescription drug costs by $22 billion over a decade.
The U.S. Department of Labor finalized a rule Wednesday requiring pharmacy benefit managers to disclose their fees and compensation to large employers that self-insure their group health plans, marking the first time such intermediaries must reveal payments received from drug manufacturers, pharmacies, and other parties in the prescription drug supply chain.
The rule, issued through the Employee Benefits Security Administration, implements transparency provisions from the Consolidated Appropriations Act, 2026, and fulfills a directive in President Trump's executive order aimed at lowering drug prices. Pharmacy benefit managers serve as middlemen for employer-sponsored health plans covering roughly 90 million Americans, yet plan fiduciaries have historically been unable to obtain a complete picture of PBM compensation.
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Under the finalized rule, PBMs must disclose rebates and other payments received from drug manufacturers, compensation earned when a plan's drug payment exceeds the amount reimbursed to a pharmacy, and fees recouped from pharmacies for drugs dispensed to plan participants. Plan fiduciaries are also granted the right to audit the accuracy of those disclosures. The rule is issued under the Employee Retirement Income Security Act's service provider prohibited transaction exemption.
Labor Secretary Keith Sonderling said the rule ends years of PBMs operating with hidden fees, while CMS Administrator Dr. Mehmet Oz framed the disclosure mandate as a competition measure expected to reduce health care costs broadly. The regulation is projected to lower prescription drug costs for health plans and participants by as much as $22 billion on an undiscounted basis over 10 years.
Employers and workers seeking guidance on the new requirements can contact EBSA at askebsa.dol.gov or by calling 866-444-3272. Continue reading at DOL News Releases and Briefs.
