Bipartisan Coalition of 45 Attorneys General Backs Pharmacy Benefit Manager (PBM) Transparency Rule

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Washington, D.C. - April 15, 2026 - Today, the National Association of Attorneys General sent a letter on behalf of a bipartisan coalition of 45 state and territory attorneys general submitted a comment letter to the U.S. Department of Labor supporting a proposed federal rule to increase transparency in pharmacy benefit manager (PBM) fee disclosure for employer-sponsored health plans governed by the Employee Retirement Income Security Act of 1974 (ERISA).

The proposed rule, titled Improving Transparency into Pharmacy Benefit Manager Fee Disclosure, would require PBMs that provide services to ERISA-covered health plans to provide more detailed, regular disclosures regarding how they generate revenue, including fees, rebates, and other forms of compensation. The rule is intended to give employers greater insight into prescription drug costs and PBM business practices and to strengthen oversight of an industry that plays a central role in the pharmaceutical supply chain.

In their comment letter, the attorneys general express support for the Department's efforts to improve transparency and accountability in the PBM marketplace. The coalition also urges the Department to clarify that the proposed rule does not preempt existing state PBM transparency and consumer protection laws. Attorneys general note that all states, the District of Columbia, and Puerto Rico have enacted legislation to regulate PBMs, reflecting widespread concern about opaque pricing practices and their impact on employers, patients, and pharmacies.

The attorneys general further encourage the Department to affirm its intent to work cooperatively with state enforcement authorities. The coalition emphasizes that clear recognition of shared federal-state oversight would reduce regulatory uncertainty, support effective enforcement, and help ensure PBMs cannot avoid accountability through jurisdictional ambiguity.

Pharmacy benefit managers administer prescription drug benefits for a significant share of Americans and exert substantial influence over drug pricing, formularies, and pharmacy reimbursement. The attorneys general state that greater transparency into PBM compensation and decision-making is essential to protecting employers, controlling healthcare costs, and promoting fair competition within the healthcare marketplace.

The attorneys general from California, Ohio, Oklahoma, and Minnesota sponsored the comment letter. Joining them are the attorneys general from Alaska, American Samoa, Arizona, Arkansas, Colorado, Connecticut, Delaware, District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, and Wyoming,.

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The National Association of Attorneys General is a nonpartisan organization of the attorneys general of the 50 states, the District of Columbia, and U.S. territories. NAAG provides a forum for exchanging knowledge, experiences, and insights on legal and law enforcement issues, and fosters bipartisan collaboration among its members to address common challenges and advance the rule of law. For more information, please visit NAAG's website.