PBM Disclosure Act
Summary
The PBM Disclosure Act aims to clarify disclosure requirements for direct and indirect compensation received by pharmacy benefit managers (PBMs) and third-party administrators (TPAs) from employer-sponsored health plans. It amends Section 408(b)(2)(B)(ii)(I)(bb) of the Employee Retirement Income Security Act of 1974 (ERISA). The bill also directs the Secretary of Labor to issue regulations clarifying these requirements within 180 days of enactment.
Expected Effects
The primary effect will be increased transparency regarding the financial relationships between PBMs, TPAs, and employer-sponsored health plans. This increased transparency is intended to help employers and plan participants better understand how PBMs and TPAs are compensated. Ultimately, this could lead to better negotiation of PBM contracts and lower prescription drug costs.
Potential Benefits
- Increased transparency in PBM and TPA compensation.
- Potential for employers to negotiate better PBM contracts.
- Possible reduction in prescription drug costs for consumers.
- Clarification of existing ERISA requirements.
- Greater accountability for PBMs and TPAs.
Most Benefited Areas:
Potential Disadvantages
- Potential for increased administrative burden on PBMs and TPAs.
- Possible legal challenges to the new regulations.
- The clarification may not significantly impact prescription drug costs.
- The 180-day timeframe for regulations may be insufficient.
- Potential for unintended consequences due to regulatory changes.
Constitutional Alignment
The bill aligns with the Commerce Clause (Article I, Section 8) as it regulates health benefits, which have a substantial effect on interstate commerce. The bill does not appear to infringe upon any specific constitutional rights. The amendment to ERISA falls under Congress's power to regulate employee benefits.
Impact Assessment: Things You Care About ⓘ
This action has been evaluated across 19 key areas that matter to you. Scores range from 1 (highly disadvantageous) to 5 (highly beneficial).