Senator Marshall Introduces Bipartisan Legislation to Hold Pharmacy Benefit Managers Accountable

Washington – On Wednesday, U.S. Senator Roger Marshall, M.D. (R-Kansas), introduced bipartisan, bicameral legislation to establish clear fiduciary responsibilities for Pharmacy Benefit Managers (PBMs), ensuring they act in the best interests of employers and workers who rely on employer-sponsored health plans governed by the Employee Retirement Income Security Act (ERISA).

The PBM Fiduciary Accountability, Integrity, and Reform Act, or PBM FAIR Act, would require PBMs to operate as fiduciaries, obligating them to prioritize the financial and health interests of ERISA-covered group health plans in every decision they make. By doing so, the legislation would help prevent PBMs from doing things like steering plans toward higher-cost branded drugs with larger rebates when lower-cost generics or biosimilars are available.

“For too long, middlemen have used opaque pricing and misaligned incentives to line their own pockets at the expense of employers,” said Senator Marshall. “PBMs shouldn’t profit by steering plans toward higher‑cost drugs or practices that drive up prices. This bill holds them accountable and ensures that every decision they make prioritizes the health and financial interests of the plans and people they serve.”

This legislation is cosponsored by Senators Tim Kaine (D-Virginia), Chuck Grassley (R-Iowa), and Maggie Hassan (D-New Hampshire) in the Senate and is led by Representatives Jake Auchincloss (D-Massachusetts) and Ryan Mackenzie (R-Pennsylvania) in the House.

This legislation is supported by the ERISA Industry Committee (ERIC).

“Employers, workers, and families should be able to rely on those who provide services to employer-sponsored group health plans, such as pharmacy benefit managers, to adhere to the same fiduciary duties the employer is held to. That means working to save money for patients, and doing what is right for the plan’s beneficiaries. Today’s unregulated, “honor system” approach is not working. When PBMs are performing services on behalf of the employer, they are standing in the shoes of the plan sponsor and should be held accountable. ERIC applauds Senators Marshall, Kaine, Grassley, and Hassan for leaving politics at the door and taking a bipartisan approach to clarify this important extension of current law,” said James Gelfand, President and CEO, ERIC.

Click here to read the full text of S.3549.

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Contact: Payton Fuller