PBM disclosure and rebate pass-through provisions enacted with government funding legislation

On February 3, 2026, President Donald Trump signed legislation that will require pharmacy benefit managers (PBMs) to disclose detailed information to group health plan sponsors and group health insurance issuers. It also requires rebates to be passed directly to plan sponsors.

The provisions, which are included in the Consolidated Appropriations Act, 2026, will take effect for plan years that begin on or after August 3, 2028 (30 months after the date of enactment). For calendar-year plans, the provisions will take effect for plan years beginning on or after January 1, 2029.

PBM transparency

PBMs will be required to provide detailed disclosure to insured and self-insured group health plans. They must provide the reports at least semiannually (plan sponsors may request that they be provided at least quarterly).

Among other information, the reports must disclose the following:

• Information about specific drugs for which claims were filed during the reporting period
• Information on the wholesale acquisition costs for drugs
• Amounts the plan or plan sponsor paid for drugs
• Amounts the PBM paid pharmacies
• Amounts paid by participants and beneficiaries through copayments, coinsurance and deductibles
• Information on dispensing channels
• Information about total remuneration for a drug and formulary information

Summary documents would also be required and would be available to participants and beneficiaries upon request.

The Department of Health and Human Services, DOL and the Department of the Treasury will provide a standard format for the required reports and issue rules. The sample report and rules are due no later than 18 months after the date of enactment.

Pass-through drug manufacturer rebates

PBMs will be required to pass drug manufacturer rebates, fees, discounts and remuneration (other than bona fide service fees) to ERISA-covered group health plans or the plan sponsors. The provision will be effective for new contracts, extensions or renewals entered into for plan years beginning on or after August 3, 2028 (30 months after the date of enactment).

Note: These provisions are separate from ­— and in addition to — existing Prescription Drug Data Collection requirements and recently proposed DOL rules requiring PBM fee disclosure information to self-insured group health plans. Comments on those proposed rules are due March 31, 2026; as proposed, they would apply to plan years beginning on or after July 1, 2026.

Going forward

Employer plan sponsors should 1) review the PBM disclosure and rebate pass-through provisions; 2) monitor for additional developments; and 3) prepare to ensure that new contracts, renewals and extensions incorporate the new requirements after the effective date.