Labor Department Finalizes Rule Requiring PBM Fee Disclosures

The U.S. Department of Labor finalized a rule Tuesday requiring pharmacy benefit managers to disclose their fees and compensation arrangements to large employers that sponsor self-insured group health plans, marking the first time such intermediaries must reveal payments received from drug manufacturers, pharmacies, and other parties in the drug supply chain.

The regulation, issued under the Employee Retirement Income Security Act's service provider prohibited transaction exemption, applies to health plans covering roughly 90 million Americans. Officials say employers have long been unable to obtain a complete accounting of what PBMs and their affiliates collect, limiting their ability to negotiate contracts or reduce costs passed on to workers.

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The final rule implements transparency reforms Congress passed as part of the Consolidated Appropriations Act, 2026, and fulfills a directive in President Trump's executive order aimed at making the prescription drug market more accountable. The Labor Department projects the rule could lower prescription drug costs for health plans and participants by as much as $22 billion on an undiscounted basis over 10 years.

Under the new requirements, PBMs must disclose rebates and other manufacturer payments, compensation earned when a plan's drug payment exceeds pharmacy reimbursement, and amounts recouped from pharmacies for drugs dispensed to plan participants. Plan fiduciaries will also gain the right to audit the accuracy of PBM disclosures and receive added protections if a PBM fails to comply.

Labor Secretary Keith Sonderling and CMS Administrator Dr. Mehmet Oz both characterized the rule as a step toward greater market competition and lower health care costs. Continue reading at DOL News Releases and Briefs.