State laws designed to regulate pharmacy benefit managers (PBMs) have expanded significantly in recent years, but are these reforms providing meaningful relief for independent pharmacies? While some states have successfully implemented reimbursement protections, transparency requirements, and pharmacy audit reforms, enforcement remains a significant challenge. Without effective oversight and clear mechanisms for addressing violations, pharmacies may struggle to benefit from the protections these laws are intended to provide.
In a recent Drug Topics Q&A following the 2026 National Community Pharmacists Association (NCPA) Annual Convention & Expo, Frier Levitt attorney A.J. Barbarito discusses the effectiveness of state PBM reforms, the legal limitations imposed by the Employee Retirement Income Security Act (ERISA) and Medicare Part D preemption, and the challenges pharmacies face when state agencies lack the resources or authority to enforce existing laws. A.J. also examines how allowing pharmacies to pursue legal action directly against PBMs through a private right of action could strengthen compliance and provide a more effective path to relief.
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