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If you’ve worked in a pharmacy in the past decade, you know the pain: clawbacks, spread pricing, and shrinking reimbursements. After years of advocacy, the system is finally changing.
On February 3, 2026, President Trump signed the Consolidated Appropriations Act, officially making PBM reform law. This legislation, years in the making, brings new transparency, accountability, and opportunity to our profession. It isn’t just another promise. It’s real.
What’s changed for you?
- More transparency: PBMs must now provide detailed, twice-yearly reports to employer plans on drug spending, rebates, and benefit designs, information that must also be shared with patients.
- No more rebate games: PBMs must pass 100% of manufacturer rebates to their clients within 90 days of each quarter. No more pocketing the difference.
- Flat fees only: By 2028, PBMs can’t profit from rebates or volume deals. They’ll be paid only fair-market flat fees for services performed.
- Open networks: Any pharmacy meeting contract standards can join prescription drug plan networks, opening new doors for independents and communities.
- Protection for speaking up: Pharmacies now have a formal way to report PBM contract violations, with penalties for retaliation.
What leaders are saying
Michael Hogue (APhA CEO) calls this a big step forward, recognizing pharmacists’ essential role and setting the stage for better patient care. Steven Anderson (NACDS) says it’s the most important federal PBM reform yet.
But the APhA also notes what’s missing: Congress didn’t pass legislation to ensure pharmacist services like testing and vaccinations are consistently covered by Medicare. There’s more work to do.
Celebrate the win, but stay engaged
This law is a historic win, but it’s not the finish line. APhA and others are pushing for further changes, especially to expand pharmacist service reimbursement.
State level momentum is building
While federal progress made headlines, states are moving even faster. In 2025 alone, 211 bills in 44 states aimed to expand pharmacist scope and payment for patient care. Sixteen have already become law. Many focus on allowing pharmacists to test, diagnose, and prescribe for common conditions like flu and strep.
Are you ready for what’s next?
Laws are changing, but are you prepared to take advantage?
- Learn your state’s current and pending pharmacy laws.
- Get involved with your state pharmacy association.
- Build your clinical and billing skills. Medical billing, test-and-treat, and collaborative practice agreements are now real career opportunities.
- Understand how these changes will reshape your business and patient care.
The big picture
Pharmacy is at a turning point. The old barriers are coming down, thanks to lawmakers, courts, and patient demand.
But laws only open the door. You must walk through it.
Stay informed. Stay involved. And keep moving forward, because the profession is changing, and you have a chance to help shape its future.
What questions does this raise for you? How will you prepare for these changes? Let’s keep the conversation going, your voice matters.
Sources: Pharmacy Times, PR Newswire / APhA, Mintz Law, Buchanan Ingersoll & Rooney, FMI, NASPA, Drug Topics, GovTrack.us, Groom Law Group, Forvis Mazars, Crowell & Moring, AMA Advocacy Update
