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Two additional PBM bills introduced: ownership ban and fiduciary duty draw mixed reactions
Summary
Representative Kim Wallen introduced two companion PBM measures Feb. 4 that would (1) bar insurers from owning PBMs licensed in Oregon and (2) impose a statutory fiduciary duty on PBMs to act in patients’ interests.
Representative Kim Wallen introduced two bills related to pharmacy benefit managers during the committee’s Feb. 4 session and gave brief testimony on each.
Wallens’s first measure, House Bill 2,252, would prohibit a PBM licensed in Oregon from being owned by an insurer or from owning an insurer. The goal, she said, is to constrain vertical integration that can create conflicts when a PBM and an insurer (or a PBM and a pharmacy chain) are under common ownership.
"This would just simply say that if you have a PBM license in Oregon, you would have to prove to DCBS's satisfaction that you are not owned by or do not own an insurer," Wallen told the committee. She said the measure is intended to be a straightforward tool against integration that critics say can steer business to affiliated pharmacies.
Wallen’s second bill, House Bill 2,253, would create a statutory fiduciary duty requiring PBMs to consider patients’ interests when administering pharmacy benefits. Supporters argued that PBMs act as a neutral intermediary but do not today bear the same legal obligation to beneficiaries as payers or plans.
Pharmacists and several pharmacy owners voiced support for the fiduciary proposal, saying it would align PBM duties with the patient‑centered responsibilities held by prescribers and pharmacists. "I support this bill," pharmacy owner John Murray said, arguing the change would hold PBMs to a higher standard of accountability for whether negotiated benefits actually reach patients.
Plans and PBMs warned the fiduciary language would create legal conflicts and private‑law exposure. Bill Head of the Pharmaceutical Care Management Association said a statutory fiduciary duty is a legal standard that normally applies to actors who control plan assets, and that imposing it on PBMs — vendors to plans — would create litigation risk and conflict with existing plan fiduciary rules. Mary Ann Cooper of Cambia (Regence) told the committee a narrow fiduciary obligation could in practice force PBMs to pursue the lowest price without regard to access and network adequacy, undermining the careful balancing insurers currently perform when setting formularies and networks.
The committee did not take action on either bill and carried the measures to additional hearings. Chair Noss and committee staff asked stakeholders to continue discussions and to try to identify narrower legislative language for areas where agreement might be possible.
