Lawmakers’ PBM Overhaul Set to Boost Insurance Transparency

Provisions targeting pharmacy benefit managers in a government funding agreement are poised to inject more transparency into health insurance costs and limit third-party vendors’ efforts to escape scrutiny.

A bill this week to fund the Department of Health and Human Services and other agencies includes measures requiring pharmacy benefit managers to pass drugmaker rebates through to employers in the commercial market as well as Medicare Part D plans. The bill also includes detailed reporting requirements around pricing and distribution, and clarifies that previous disclosure requirements apply to a broad range of third-party service providers.

The bill may significantly affect how ...