A Republican bill with 2 Democratic cosponsors · See all 3 cosponsors
Last activity — Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
In committee
Introduced and handed to a committee in the chamber it started in.
The committee holds it, and most bills are never heard from again. A hearing or a committee vote would be news; silence is the usual outcome, and it kills the bill without anyone voting against it.
Its path through Congress
- 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
- Scored +6
Does this give people more protection from unfair business practices?
Mandates fiduciary standards and compensation disclosures for pharmacy benefit managers to protect health plans and consumers.
- Scored +5
Does this make what the government does easier for the public to see?
Requires explicit compensation disclosures and holds pharmacy benefit managers accountable to legal standards.
- Scored +4
Would union members be better off under this?
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. Tap or hover a score for the reason it gave.
- Demographic And Interest Groups
- Would union members be better off under this? — Protects multiemployer and union-sponsored group health plans from hidden fees and conflicts of interest. Would business owners be better off under this? — Assists plan sponsors and business owners by ensuring transparency in PBM and third-party administrator compensation. Would middle-income households be better off under this? — Helps middle-class families by increasing transparency and oversight of prescription drug pricing. Would retired people be better off under this? — Aids retirees relying on employer-provided health benefits by regulating pharmacy benefit managers. Would people over 65 be better off under this? — Brings greater fiduciary accountability to entities managing prescription drug benefits. Would children be better off under this? — Ensures better oversight of family health plan prescription benefits. Would households on low incomes be better off under this? — Enhances financial protections within group health plans that can benefit lower-income workers. Would people in middle age be better off under this? — Protects individuals relying on employer-sponsored health coverage from hidden drug supply chain costs. Would people with disabilities be better off under this? — Supports individuals who rely heavily on continuous prescription drug therapies through better supply chain accountability. Would people in their twenties and thirties be better off under this? — Improves transparency and potential affordability for individuals covered under employer-sponsored health plans. Would high-income households be better off under this? — Provides general market clarity for individuals with private insurance coverage.
- Economy And Finance
- Does this give people more protection from unfair business practices? — Mandates fiduciary standards and compensation disclosures for pharmacy benefit managers to protect health plans and consumers. Is this likely to grow the economy? — Increases financial transparency and accountability in prescription drug management markets. Does this make the government pay for what it commits to? — Promotes better financial stewardship by holding pharmacy benefit managers to fiduciary standards. Does this make it easier to run a small business? — Provides small businesses sponsoring group health plans with greater transparency regarding PBM compensation.
- Healthcare
- Does this lower the price of prescription medicines? — Requiring PBMs to act as fiduciaries and disclose compensation helps rein in hidden costs associated with prescription drugs. Does this lower what people pay for private health insurance? — Fiduciary accountability and transparency for pharmacy benefit managers could help lower overall group health plan costs. Does this make health care easier to get in general? — Brings better oversight and accountability to prescription drug formularies and provider networks.
- Governance And Ideology
- Does this make what the government does easier for the public to see? — Requires explicit compensation disclosures and holds pharmacy benefit managers accountable to legal standards. Does this give the federal government more power? — Expands federal regulatory requirements under ERISA for pharmacy benefit managers.
- 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