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The public comment period is now closed for a Department of Labor proposed rule for improving transparency in pharmacy benefit manager fees.
The Department of Labor opened comment on Jan. 30 and closed it on April 15. The rule, designed to increase transparency for self-insured employer health plans, is on an accelerated timeline.
The proposed rule would require PBMs to disclose all direct and indirect compensation to employer and union health plan sponsors, improving transparency and helping fiduciaries identify conflicts of interest.
Health and Human Services Secretary Robert F. Kennedy Jr. said in testimony before Congress that the effort is part of a broader push for healthcare price transparency.
Most stakeholders voiced support in public comments, and many urged the DOL to go further by expanding it to all health plan service providers.
Fourteen financial officers spanning 12 states submitted a comment letter stating: "State financial officers support the Proposed Rule because they have a vested interest as fiduciaries of public investment funds in ensuring that corporations in which those funds hold shares are preserving shareholder value by controlling group health plan costs … to enable truly effective fiduciary oversight, however, the Department should take two additional steps. First, expand the Proposed Rule's coverage to all health plan service providers (including third-party administrators ('TPAs') and insurers for fully insured plans). … Second, expand fiduciary access to claims data, payments to providers, and pricing data, rather than just compensation summaries."
Former top health advisor at the White House Domestic Policy Council Katy Talento said: "In my professional judgment, this proposed rule is one of the most important federal actions in years to restore basic honesty and fiduciary discipline to the employer-sponsored prescription drug market. … I encourage the Department to move decisively toward robust clarity applying all the same rules proposed for PBMs to TPAs, and every other service provider. … Please finalize this rule promptly with the correction on the pricing formula loophole. Please make it effective January 1, 2027."
Email the writer: SMorse@himss.org