The House has added measures to the Consolidated Appropriations Act (CAA), 2026, an appropriation bill or spending package, that include transparency requirements for PBMs. These requirements are included in a provision designed to lower drug costs by giving drug manufacturers more tools to secure approval for generic drugs from the U.S. Department of Health and Human Services (HHS). The provision would also add to an existing list of entities that the Employee Retirement Income Security Act (ERISA) requires health plan fiduciaries to monitor.
More specifically, the provision would require PBMs to provide fiduciaries with prescription drug benefits-tracking reports, which would allow fiduciaries to measure the cost-effectiveness of these benefits for plan participants. Furthermore, PBMs would be required to pass all rebates and other negotiated discounts on to plan fiduciaries, rather than retaining them. Finally, “covered service providers,” or entities involved in prescription
