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H.R. 6837 would establish that pharmacy benefit managers (PBMs) must be treated as fiduciaries under federal employee retirement and health plan laws, meaning they would have legal obligations to act in the best interest of workers and retirees rather than prioritizing their own profits. The bill requires PBMs and third-party administrators to disclose all compensation they receive—both direct and indirect—and prohibits them from being indemnified or protected from liability for breaching their duties. The legislation also clarifies that PBMs cannot serve as the responsible fiduciary making disclosure decisions for plans, with a narrow exception for PBMs managing their own employee plans. The changes would take effect 12 months after the bill becomes law and would apply to all group health plans including those covering federal employees and private sector workers. This legislation aims to increase transparency and accountability in how PBMs negotiate drug prices and manage prescription drug benefits on behalf of health plans.

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