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ARTICLE · 16 FEBRUARY 2026

PBM Transparency: Next Steps For Plan Sponsors

Ballard Spahr LLP
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The federal government recently delivered back-to-back measures forcing pharmacy benefit managers (PBMs) to be more transparent about their business models.

United StatesEmployment and HR
D. Finn Pressly
D. Finn Pressly
Edward I. Leeds
Edward I. Leeds
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The federal government recently delivered back-to-back measures forcing pharmacy benefit managers (PBMs) to be more transparent about their business models. However, with this heightened transparency comes a host of new fiduciary obligations for sponsors of health and welfare benefit plans.

New Requirements

Reforming the PBM industry has been a frequent talking point for the past decade. State legislatures were the first to take concrete steps toward PBM industry regulation, with states like Arkansas and Florida passing statutes demanding pass-through rebate payments, an end to spread pricing, and more expansive access to independent pharmacies, measures that have raised significant Employee Retirement Income Security Act of 1974 (ERISA) preemption issues.

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