Industry
Bipartisan Federal Legislation Targets PBM Vertical Integration
Two states have enacted laws barring pharmacy benefit managers from owning retail pharmacies, addressing vertical integration models like CVS Health's. A federal bill with bipartisan sponsors would extend this prohibition nationwide. The proposal unites Republicans traditionally opposed to market intervention with Democrats more comfortable with regulatory oversight. For Medicaid managed care plans and carved-out PBM arrangements, any federal restriction on vertical integration would fundamentally reshape pharmacy network structures and vendor contracting options.
Why it mattersFederal vertical integration limits would force MCOs and states to restructure PBM contracts and pharmacy networks, potentially eliminating major vendor options and requiring new procurement strategies.