DOL to issue final PBM fee disclosure rule Thursday

The Labor Department is expected to release the final version of its pharmacy benefit manager fee disclosure rule Thursday, PLANADVISER reported Wednesday.

The rule, Improving Transparency Into Pharmacy Benefit Manager Fee Disclosure, would require PBMs to disclose all direct and indirect compensation to ERISA plan fiduciaries.

Plan sponsors and advisers would get the PBM's direct and indirect compensation in writing, the disclosure Representative Ryan Mackenzie said employers need to compare competing PBM proposals. For an adviser whose book includes a sponsor's group health plan, that accounting becomes a document in the fiduciary file rather than a figure inferred from a bundled bid that mixes drug spend, rebates and administrative fees.

The rule aligns with the Consolidated Appropriations Act of 2026, which requires PBMs to pass through 100% of rebates, fees, alternative discounts and other remuneration received from drug manufacturers and related entities to the ERISA plan. It is written to match that law's reporting requirements.

At a Wednesday media briefing, Mackenzie, R-Pennsylvania, and healthcare benefits experts endorsed the pending rule, describing it as vital alongside bipartisan congressional action to establish "net effective cost" as the standard for prescription drug pricing across the healthcare market.

"To make informed decisions, employers need a clearer picture of what they're actually paying for prescription drugs," Mackenzie said. "That means accounting for rebates, discounts, fees and other financial arrangements that make it difficult to determine the true cost of their health benefit plans."

Mackenzie and Representative Lucy McBath, D-Georgia, introduced the Net Effective Cost Transparency and Prescription Drug Affordability Act in September. Representatives Jake Auchincloss, D-Massachusetts, Rick Allen, R-Georgia, and Carol Miller, R-West Virginia, co-sponsored. Mackenzie also introduced the PBM Fiduciary Accountability, Integrity and Reform Act in December, which would establish fiduciary responsibilities for PBMs under ERISA. He said the two bills complement the DOL rule and would require PBMs to act as fiduciaries in the best interest of employers and their health plans.