New Guidance Puts PBM Transparency Lawsuit in Limbo

Mere days after the top PBM trade group filed suit against a regulation requiring PBMs to report historical net prices of prescription drugs, the Biden administration issued guidance that effectively says that provision won’t be enforced anytime soon.

Still, it’s not yet certain what the Pharmaceutical Care Management Association (PCMA) or the U.S. Chamber of Commerce — which filed a similar suit against the so-called “transparency in coverage” rule — plan to do regarding their litigation. And one health plan trade group wants the administration to do more to address its concerns about the price transparency regulation.

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Leslie Small

Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.

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