Department of Labor Proposed New PBM Disclosure Rules
The rule seeks to increase transparency by requiring pharmacy benefit managers to disclose compensation to plan fiduciaries.
Updated on Oct. 6, 2026 in Healthcare
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On January 30, 2026, the Department of Labor issued a proposed rule that would mandate pharmacy benefit managers (PBMs) disclose compensation to self-insured plan fiduciaries. This move aligns with broader regulatory efforts to increase oversight of the pharmaceutical supply chain.
Why it matters
Increasing transparency requirements for PBMs and their affiliated consultants aim to shed light on how these entities manage drug rebates and pharmacy networks. These changes address concerns regarding the influence of major PBMs, which are often owned by large insurance conglomerates.
There are 66 PBMs operating in the United States, with a massive concentration of market power as three companies processed approximately 79 percent of all prescription claims in 2022.
The players
Department of Labor
This federal agency is responsible for occupational safety, wage and hour standards, and the administration of various employee benefit programs.
The details
PBMs negotiate rebates from drug manufacturers and often route prescriptions through vertically integrated pharmacy networks they own. The new requirements follow the February 2026 signing of the Consolidated Appropriations Act 2026, which established additional reporting standards for health plans.
Timeline
In 2022, three PBMs processed 79 percent of all US prescription claims.
The Department of Labor issued the proposed rule on January 30, 2026.
The Consolidated Appropriations Act 2026 was signed into law in February 2026.
Reporting requirements under the new act take effect on January 1, 2029.
Market Landscape
This regulatory push follows the enactment of the Consolidated Appropriations Act 2026 to increase transparency in the pharmacy benefit management industry. It marks a significant shift toward stricter oversight of the vertically integrated structures maintained by major insurance conglomerates.
For employers and employees with self-insured health plans, this rule could lead to greater visibility into pharmacy benefit costs and potential price negotiations. Increased oversight may eventually influence the cost structures of employer-sponsored health benefits.
The takeaway
The proposed rule represents a regulatory step toward curbing the opaque nature of pharmacy benefit management. Consumers and plan sponsors should watch for how these disclosure requirements impact the management of drug rebates and pharmacy access over the next several years.
What happens next
Reporting requirements under the Consolidated Appropriations Act 2026 will officially take effect for all plans renewed or entered into on or after January 1, 2029.
Further reading
For more information on national medical policy, visit the Healthcare section.
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