Legislation & Regulation

All 50 states have enacted some sort of pharmacy benefit manager (PBM) legislation, but a handful are setting the pace in terms of new laws targeting ownership restrictions, transparency requirements, and compensation models.

Pharmacy benefit manager (PBM) reform is evolving rapidly at the state level, creating a complex and often fragmented policy landscape that stakeholders must actively monitor. Understanding which reforms are advancing in each state is critical, as these policies can significantly alter drug pricing dynamics, rebate structures, formulary design, and patient access.

AMCP members gathered in Washington, DC, on May 18–20 for Legislative Days 2026, to advocate for managed care's legislative priorities addressing patient access, affordability, and care delivery.

The bipartisan Main Street Pharmacy Access Act (H.R. 3164/S. 2426), which would allow Medicare to reimburse pharmacists for testing and treating certain respiratory illnesses in states that already authorize those services, cleared the House Committee on Ways and Means on May 21, 2026.