Bill · S. 3549· Senate(119-S-3549)
PBM FAIR Act
- Introduced
- 12/17/2025
- Last activity
- 12/17/2025 — Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
- Sponsored by
- Roger Marshall
- Cosponsors
- - 1 - 2
- Introduced
- In Committee
What this bill would do
This bill is known as the PBM Fiduciary Accountability, Integrity, and Reform (FAIR) Act. It amends the Employee Retirement Income Security Act of 1974 to ensure that pharmacy benefit managers are officially considered fiduciaries. The legislation requires pharmacy benefit managers and third-party administrators to disclose certain compensation. It also prohibits these newly defined fiduciaries from being indemnified or relieved from liability for breaches of their duties. Finally, the amendments apply to plan years beginning at least 12 months after the date of enactment.
Yes· 3 of 20
Does this give people more protection from unfair business practices?+6
Mandates fiduciary standards and compensation disclosures for pharmacy benefit managers to protect health plans and consumers.
Does this make what the government does easier for the public to see?+5
Requires explicit compensation disclosures and holds pharmacy benefit managers accountable to legal standards.
Would union members be better off under this?+4
Protects multiemployer and union-sponsored group health plans from hidden fees and conflicts of interest.
The opposite
No question was scored the opposite.
Who it would affect, and how
Potential Positive Impacts for People
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Fiduciary Accountability for Pharmacy Benefit Managers: Under Section 2(a), pharmacy benefit managers are deemed to be fiduciaries with respect to a group health plan if they maintain provider networks or formularies, negotiate rebates, process claims, or perform utilization review. This is positive because it holds these entities to a higher legal standard of putting the plan's interests first.
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Required Compensation Disclosures: Section 2(b) requires pharmacy benefit managers and third-party administrators to provide required compensation disclosures for services provided to a covered plan. This is positive as it brings financial transparency to the services and compensation expected by providers and their affiliates.
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Prohibition on Indemnification: Section 2(d) adds provisions stating that no person or entity deemed to be a fiduciary under the new rules may be indemnified or relieved from liability for their responsibilities and duties. This provision protects the people by ensuring that these entities cannot write contracts that excuse them from accountability for breaking their duties.
Potential Negative Impacts for People
- Potential Burdens from Liability Restrictions: Under Section 2(d), any contract provision that attempts to indemnify or relieve these fiduciaries from liability is made void as against public policy. While this holds officials accountable, it may lead to increased operational or legal costs for plans and providers that could potentially be passed down to everyday individuals.
Groups and Interests Ranking
Every group the model scored this bill for, from -10 to +10. Hover a score for the reason it gave.
- Demographic And Interest Groups
- Good For Union Workers+4Good For Business Owners+3Good For Middle Class Households+3Good For Retirees+3Good For Seniors+3Good For Children+2Good For Low Income Households+2Good For Middle Aged+2Good For People With Disabilities+2Good For Young Adults+2Good For High Income Households+1
- Economy And Finance
- Improves Consumer Protection+6Improves Economic Growth+2Improves Fiscal Responsibility+2Improves Small Business Support+1
- Healthcare
- Reduces Prescription Drug Costs+4Reduces Private Insurance Premiums+3Improves Healthcare Access+2
- Governance And Ideology
- Improves Government Transparency+5Increases Federal Power+2
- 12/17/2025
- Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
- 3 Cosponsors added.
- Introduced in Senate
One bill Congress.gov lists as related to this one — companions in the other chamber, earlier versions, and bills this one absorbed or was folded into.
Chuck GrassleyRepublican · Iowa
Maggie HassanDemocrat · New Hampshire
Timothy KaineDemocrat · Virginia