[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 3549 Introduced in Senate (IS)]

<DOC>






119th CONGRESS
  1st Session
                                S. 3549

To amend the Employee Retirement Income Security Act of 1974 to ensure 
  that pharmacy benefit managers are considered fiduciaries, and for 
                            other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           December 17, 2025

  Mr. Marshall (for himself, Mr. Kaine, Mr. Grassley, and Ms. Hassan) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To amend the Employee Retirement Income Security Act of 1974 to ensure 
  that pharmacy benefit managers are considered fiduciaries, and for 
                            other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``PBM Fiduciary Accountability, 
Integrity, and Reform (FAIR) Act'' or the ``PBM FAIR Act''.

SEC. 2. ESTABLISHING FIDUCIARY DUTIES OF PHARMACY BENEFIT MANAGERS.

    (a) Deeming Pharmacy Benefit Managers as ERISA Fiduciaries.--
Section 3(21) of the Employee Retirement Income Security Act of 1974 
(29 U.S.C. 1002(21)) is amended by adding at the end the following:
    ``(C) A person or entity shall be deemed to be a fiduciary with 
respect to a group health plan for the purposes of this Act if the 
person or entity--
            ``(i) maintains for the group health plan, the plan sponsor 
        or plan administrator of such plan, or a health insurance 
        issuer offering group health insurance coverage a prescription 
        drug provider network or prescription drug formulary through 
        the purchase of prescription drugs from a drug manufacturer, 
        distributor, wholesaler, rebate aggregator, group purchasing 
        organization, or any associated third party; or
            ``(ii) engages in, on behalf of, or in connection with, the 
        group health plan, the plan sponsor or plan administrator of 
        such plan, or a health insurance issuer offering group health 
        insurance coverage--
                    ``(I) the negotiation or aggregation of rebates, 
                fees, discounts, or other price concessions for 
                prescription drugs;
                    ``(II) the processing and payment of claims for 
                prescription drugs; or
                    ``(III) the performance of utilization review and 
                management for prescription drugs on behalf of a group 
                health plan.''.
    (b) Required Compensation Disclosures From Pharmacy Benefit 
Managers and Third Party Administrators.--Section 
408(b)(2)(B)(ii)(I)(bb) of the Employee Retirement Income Security Act 
of 1974 (29 U.S.C. 1108(b)(2)(B)(ii)(I)(bb)) is amended by adding at 
the end the following:
                            ``(CC) Pharmacy benefit management services 
                        provided to a covered plan, for which the 
                        covered service provider, an affiliate, or a 
                        subcontractor reasonably expects to receive 
                        indirect compensation or direct compensation 
                        described in item (dd), including the 
                        establishment and maintenance of a prescription 
                        drug provider network or prescription drug 
                        formulary or through the purchase of 
                        prescription drugs from a drug manufacturer, 
                        distributor, wholesaler, rebate aggregator, 
                        group purchasing organization, or any 
                        associated third party for the covered plan.
                            ``(DD) Third party administrative services 
                        provided to a covered plan, for which the 
                        covered service provider, an affiliate, or a 
                        subcontractor reasonably expects to receive 
                        indirect compensation or direct compensation 
                        described in item (dd), including establishing 
                        and maintaining a network of medical providers, 
                        adjudicating or processing health claims, 
                        maintaining records, and negotiating 
                        reimbursement rates for the covered plan.''.
    (c) Clarification of Responsible Plan Fiduciary.--Section 
408(b)(2)(B)(ii)(I)(ee) of the Employee Retirement Income Security Act 
of 1974 (29 U.S.C. 1108(b)(2)(B)(ii)(I)(ee)) is amended by inserting at 
the end the following: ``A covered service provider may not be the 
responsible plan fiduciary for purposes of the disclosures required 
under clause (iii). Notwithstanding the preceding sentence, in the case 
of a pharmacy benefit manager who sponsors a covered plan for the 
employees of the pharmacy benefit manager, the pharmacy benefit manager 
may be considered the responsible plan fiduciary for such plan.''.
    (d) Prohibition on Indemnification for Breaches by a Section 
3(21)(C) Fiduciary.--Section 410(a) of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1110(a)) is amended--
            (1) by striking ``Except'' and inserting ``(1) Except''; 
        and
            (2) by adding at the end the following:
    ``(2) Except as provided in subsection (b)(2), no person or entity 
deemed to be a fiduciary under section 3(21)(C) may be indemnified, 
directly or indirectly, or otherwise relieved from liability for any 
responsibility, obligation, or duty of such person or entity under this 
part.
    ``(3) Any provision of contract in violation of paragraph (2) shall 
be void as against public policy.''.
    (e) Technical Amendment.--Section 408(b)(2)(B)(i) of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 1108(b)(2)(B)(i)) is 
amended by striking ``this clause'' and inserting ``this 
subparagraph''.
    (f) Effective Date.--The amendments made by this section shall 
apply with respect to plan years beginning with the first plan year 
that begins at least 12 months after the date of enactment of this Act.
                                 <all>