CMS asks for data on pharmacy benefit manager pay and structure
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Table of Contents
The Centers for Medicare & Medicaid Services is asking for information on how pharmacy benefit managers, or PBMs, operate. This request focuses on two new laws that will take effect in 2028. One law limits the payments PBMs can receive from drug manufacturers. The other requires PBMs to report more data about their business practices.
Why it matters: This is a fact-finding step, not a final rule. However, the answers provided by industry groups and other stakeholders will shape how CMS defines key terms like “affiliate” and “bona fide service fee.” These definitions determine who has to comply with new reporting requirements and payment limits in 2028.
Who it affects
- Pharmacy benefit managers
This notice comes from the Centers for Medicare & Medicaid Services as part of the Federal Register; check the original document at Regulations.gov before relying on these details.
Agency: Health and Human Services Department, Centers for Medicare & Medicaid Services
Source: Federal Register — read the official document