DOL’s Proposed PBM Fee Disclosure Rule: Key Themes from the Public Comments

Short summary

The DOL's proposed PBM fee disclosure rule generated 564 public comments addressing interaction with the Consolidated Appropriations Act of 2026. Stakeholders split into four positions: implement as-is, amend for alignment, strengthen protections, or withdraw entirely. Key concerns include DOL statutory authority, APA compliance, and infeasibility of July 2026 effective date.

• •Four competing stakeholder positions on DOL rule: support as-is, technical amendments, stronger patient protections, or full withdrawal
• •Legal challenges centered on DOL's authority under ERISA §408(b)(2) and Administrative Procedure Act compliance
• •Implementation concerns focus on July 2026 effective date being too aggressive given required systems updates, contract renegotiation, and staff training

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