Fitch, 45 attorneys general support DOL PBM transparency rule
JACKSON — Mississippi Attorney General Lynn Fitch joined a bipartisan coalition of 45 attorneys general on Friday in submitting a comment letter to the U.S. Department of Labor supporting a proposed rule that would require greater transparency from pharmacy benefit managers that service employer-funded health plans covered under the Employee Retirement Income Security Act.
“PBMs have taken from the health care economy for far too long without giving back,” Fitch said. “It is past time that there is accountability and an increase in transparency. I am proud to join my colleagues as we stand with consumers and community health providers to prevent PBMs from taking advantage of Mississippians.”
The proposed rule would require PBMs to disclose twice a year how they generate revenue and would give employers the right to audit them. About 136 million Americans receive health coverage through an employer, and the rule responds to concerns that employers often lack visibility into how PBMs make money or why drug costs change.
The attorneys general urged the Department to clarify that the proposed rule does not preempt state PBM transparency laws and to state that the Department will work with state attorneys general on enforcement. In their letter the AGs asked the Department to recognize “that state attorneys general play an important role in overseeing pharmacy benefit manager practices under applicable state law” and said nothing in the rule should preclude consultation, coordination, information sharing or referrals to state attorneys general where appropriate, the letter said.
Industry concentration has drawn scrutiny: the top three PBMs manage about 80 percent of prescription drug claims, and every state, the District of Columbia and Puerto Rico have enacted laws targeting PBM practices. Fitch has pursued multiple actions against PBMs, including a $55.5 million settlement with Centene in 2021 that required transparency in adjudication and payment of pharmacy claims, a 2021 suit alleging PBM involvement in an insulin pricing scheme, a 2024 lawsuit related to the opioid epidemic and a suit last year to enforce Mississippi law on pharmacy reimbursement. In submitting the letter, Fitch joined the attorneys general of Alaska, American Samoa, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, the District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Vermont, Virginia, Washington, West Virginia and Wyoming.
We will provide more information as it becomes available.
