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PBM Contracts Could Expose Plan Sponsors to Fiduciary Liability

Summary by LexBlog

March 5, 2025. By Anne Tyler Hall and Tim Kennedy*-Hall Benefits Law A plan sponsor’s fiduciary duty to be transparent in Pharmacy Benefit Manager contracts safeguards plan participants’ interests and mitigates the risk of litigation, regulatory penalties, and reputational harm, say Hall Benefits Law practitioners. Pharmacy Benefit Managers (PBMs), particularly the Big 3 PBMs (CVS Caremark, Express Scripts, and OptumRx), have leveraged their mar…

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Missouri Business Alert

Years later, Centene settlements with states still unfinished

At least 20 states have settled with Centene Corp. over its pharmacy benefit manager operation that coordinated medications for Medicaid patients.

26 days ago

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PCMA

PBMs Continue To Deliver Savings On Prescription Drugs For Patients

By negotiating directly with drug companies to lower prices, promoting competition, and managing prescription drug benefits efficiently, PBMs continue to be a critical force in keeping medications affordable and accessible for patients. PBMs are delivering real savings and value for patients, employers, and taxpayers by working to lower drug costs and helping employers and unions offer competitive pharmacy benefits, while giving patients more co…

26 days ago

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RetailWit

Transparency vs. Reality: Troubling Lessons from PBM Disclosure Laws – RetailWit

Last week, President Trump signed yet another executive order, this time promising to make healthcare pricing more transparent. While this marks another federal push for disclosure, states have already been quite active in this space. Since 2017, 24 states have passed 38 laws targeting healthcare transparency, with a strong focus on unraveling the complex economics of pharmacy benefit managers (PBMs). But has all this legislation actually provid…

27 days ago

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LexBlog

PBM Contracts Could Expose Plan Sponsors to Fiduciary Liability

27 days ago

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OneDigital

White House Releases New Executive Order on Healthcare Price Transparency

The Trump administration has released another executive order (EO) with the potential to impact employers. It is titled “Making America Healthy Again by Empowering Patients with Clear, Accurate, and Actionable Healthcare Pricing Information”. This EO, intended to increase enforcement of price transparency requirements, orders the Department of Labor, Treasury, and Department of Health and Human Services (the Departments) to “improve existing pri…

28 days ago

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