A bipartisan bill introduced in December 2025 would amend ERISA to designate PBMs (Pharmacy Benefit Managers) as fiduciaries when they provide services to employer-sponsored health plans.

Under the proposal, PBMs would be legally required to act in the best interests of plan sponsors and participants, similar to how ERISA already treats other service providers.

Additionally, PBMs would be required to disclose their compensation, including direct and indirect fees, rebates, discounts, and price concessions.

Proponents argue this increased transparency and fiduciary accountability will help employers better assess whether PBM arrangements are reasonable and aligned with plan cost-management goals. This in turn would address longstanding concerns about opaque pricing practices and misaligned incentives in the PBM industry.

Proposed Legislation Text

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