,,ii  #aaith ,,congress  #ast ,session  
,s4 #cedi  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,december #ag1 
#bjbe,mr4 ,marshall 7for himself1 ,mr4  
,kaine1 ,mr4 ,grassley1 and ,ms4        
,hassan7 introduced the following bill2 
which was read twice and referred to the
 ,committee on ,health1 ,education1     
,labor1 and ,pensions  ,a ,,bill  ,to   
amend the ,employee ,retirement ,income 
,security ,act of #aigd to ensure that  
pharmacy benefit managers are considered
 fiduciaries1 and for other purposes4   
#a4 ,short title ,this ,act may be cited
 as the ,,pbm ,fiduciary                
,accountability1 ,integrity1 and ,reform
 7,,fair7 ,act or the ,,pbm ,,fair ,act4
  #b4 ,establishing fiduciary duties of 
pharmacy benefit managers  7a7 ,deeming 
pharmacy benefit managers as ,,erisa    
fiduciaries ,section #c7ba7 of the      
,employee ,retirement ,income ,security 
,act of #aigd 7#bi ,u4,s4,c4 #ajjb7ba77 
is amended by adding at the end the     
following3  7,c7 ,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-- 7i7 maintains for the group    
health plan1 the plan sponsor or plan   
administrator of such plan1 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          
manufacturer1 distributor1 wholesaler1  
rebate aggregator1 group purchasing     
organization1 or any associated third   
party2 or  7ii7 engages in1 on behalf   
of1 or in connection with1 the group    
health plan1 the plan sponsor or plan   
administrator of such plan1 or a health 
insurance issuer offering group health  
insurance coverage-- 7,i7 the           
negotiation or aggregation of rebates1  
fees1 discounts1 or other price         
concessions for prescription drugs2     
7,,ii7 the processing and payment of    
claims for prescription drugs2 or       

7,,iii7 the performance of utilization  
review and management for prescription  
drugs on behalf of a group health plan4 
4  7b7 ,required compensation           
disclosures from pharmacy benefit       
managers and third party administrators 
,section #djh7;b77#b77;,b77ii77,i77bb7  
of the ,employee ,retirement ,income    
,security ,act of #aigd 7#bi ,u4,s4,c4  
#aajh7;b77#b77;,b77ii77,i77bb77 is      
amended by adding at the end the        
following3 7,,cc7 ,pharmacy benefit     
management services provided to a       
covered plan1 for which the covered     
service provider1 an affiliate1 or a    
subcontractor reasonably expects to     
receive indirect compensation or direct 
compensation described in item 7dd71    
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          
manufacturer1 distributor1 wholesaler1  
rebate aggregator1 group purchasing     

organization1 or any associated third   
party for the covered plan4 7,,dd7      
,third party administrative services    
provided to a covered plan1 for which   
the covered service provider1 an        
affiliate1 or a subcontractor reasonably
 expects to receive indirect            
compensation or direct compensation     
described in item 7dd71 including       
establishing and maintaining a network  
of medical providers1 adjudicating or   
processing health claims1 maintaining   
records1 and negotiating reimbursement  
rates for the covered plan4 4  7c7      
,clarification of responsible plan      
fiduciary ,section                      
#djh7;b77#b77;,b77ii77,i77ee7 of the    
,employee ,retirement ,income ,security 
,act of #aigd 7#bi ,u4,s4,c4            
#aajh7;b77#b77;,b77ii77,i77ee77 is      
amended by inserting at the end the     
following3 ,a covered service provider  
may not be the responsible plan         
fiduciary for purposes of the           
disclosures required under clause 7iii74

 ,notwithstanding the preceding         
sentence1 in the case of a pharmacy     
benefit manager who sponsors a covered  
plan for the employees of the pharmacy  
benefit manager1 the pharmacy benefit   
manager may be considered the           
responsible plan fiduciary for such     
plan44  7d7 ,prohibition on             
indemnification for breaches by a       
section #c7ba77;,c7 fiduciary ,section  
#daj7;a7 of the ,employee ,retirement   
,income ,security ,act of #aigd 7#bi    
,u4,s4,c4 #aaaj7;a77 is amended-- 7#a7  
by striking ,except and inserting 7#a7  
,except2 and  7#b7 by adding at the end 
the following3  7#b7 ,except as provided
 in subsection 7b77#b71 no person or    
entity deemed to be a fiduciary under   
section #c7ba77;,c7 may be indemnified1 
directly or indirectly1 or otherwise    
relieved from liability for any         
responsibility1 obligation1 or duty of  
such person or entity under this part4  
7#c7 ,any provision of contract in      
violation of paragraph 7#b7 shall be    

void as against public policy4  4  7e7  
,technical amendment ,section           
#djh7;b77#b77;,b77i7 of the ,employee   
,retirement ,income ,security ,act of   
#aigd 7#bi ,u4,s4,c4                    
#aajh7;b77#b77;,b77i77 is amended by    
striking this clause and inserting this 
subparagraph4  7f7 ,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 #ab months after the    
date of enactment of this ,act4