President Trump signed Executive Order 14273, "Lowering Drug Prices by Once Again Putting Americans First," on April 15, 2025. Section 12 directed the Labor Department to propose PBM fee disclosure rules within 180 days, a deadline that fell on October 12, 2025.
The proposed rule published January 30, 2026, 110 days after that deadline. A comment-period extension (FR Doc 2026-04084) published March 2, 2026, and comments closed April 15, 2026. Assistant Secretary Daniel Aronowitz signed the final rule on October 28, 2026, 561 days after the order.
In between, according to the final rule, Congress enacted the Consolidated Appropriations Act, 2026 on February 3, 2026, with PBM provisions in Division B, Title VII. The department says the final rule follows that law's 100-employee-or-participant size line. The law's 100 percent rebate pass-through and drug-spending reports apply to plan years beginning on or after August 3, 2028.