Bill > S3549

This bill, known as the PBM FAIR Act, aims to hold Pharmacy Benefit Managers (PBMs) more accountable by treating them as fiduciaries under the Employee Retirement Income Security Act of 1974 (ERISA). PBMs are companies that manage prescription drug benefits on behalf of health plans, employers, and insurance issuers. Currently, their role is not always clearly defined as a fiduciary, meaning they are not always legally obligated to act solely in the best interest of plan participants and beneficiaries. This bill clarifies that PBMs will be considered fiduciaries if they manage prescription drug networks or formularies, negotiate drug rebates and discounts, process drug claims, or conduct drug utilization reviews. It also requires PBMs and other third-party administrators to disclose all compensation they receive for services provided to health plans, including indirect payments. Furthermore, the bill prohibits PBMs from being indemnified or relieved of liability for their fiduciary duties, meaning they cannot be protected from the consequences of breaching their responsibilities, and any contract attempting to do so will be void. The bill also clarifies that a PBM cannot be the "responsible plan fiduciary" for disclosures unless they sponsor their own employee plan. These changes are intended to increase transparency and ensure PBMs prioritize the interests of the individuals covered by health plans.

Health and Social Services

https://www.congress.gov/bill/119th-congress/senate-bill/3549/all-info