Labor Department finalizes rule forcing PBMs to disclose fees to employer health plans
The US Department of Labor finalized its pharmacy benefit manager fee disclosure rule on October 29, 2026. It requires PBMs and their affiliated brokers and consultants to disclose direct and indirect compensation to large self-insured employer group health plans. The rule includes initial and semiannual disclosures and audit rights for plan fiduciaries, plus an exemption for fiduciaries when a PBM fails to disclose. Trade reports say it applies to plan years beginning on or after July 1, 2027. It implements transparency provisions Congress enacted in the Consolidated Appropriations Act, 2026.
Why it's notable: Self-insured employers will get a clearer view of how PBMs are paid, including rebates and spread pricing. That could change formulary and drug-cost decisions that affect clinics and their patients.