Labor Department proposes new PBM transparency requirements

Modern Healthcare – Thursday, January 29, 2026
By Noah Tong

Pharmacy benefit managers would have to follow new transparency requirements under a proposed rule issued Thursday by the Labor Department.

Under the proposed rule, PBMs would be mandated to disclose information to large group employers about drugmaker rebates, pharmacy reimbursements and other negotiated compensation. The disclosures would have to include services provided, payments, and arrangements with other parties in the pharmaceutical supply chain, the proposed rule said.

It would also allow employers to audit the accuracy of the disclosures and seek relief, if necessary.

PBMs negotiate rebates and fees with prescription drug manufacturers in exchange for preferred formulary placement. Employers have limited visibility into PBM contracts.

The biggest PBMs by market share, and their insurer parent companies, are under heavy scrutiny from lawmakers and upstart competitors. The House passed healthcare provisions including PBM transparency requirements in a government spending bill last week, but the Senate as of Thursday afternoon had failed to push the legislation over the finish line.

The Pharmaceutical Care Management Association, a PBM trade group, did not immediately respond to requests for comment about the proposed rule.

Comments on the proposed rule are due March 31.

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