AH106 - What You Need to Know About the DOL’s Proposed PBM Rules, with Julie Selesnick

Julie Selesnick, Executive Director of Legal and Compliance at Judi Group, joins the Astonishing Healthcare podcast for an in-depth discussion on the Department of Labor's proposed rules aimed at enhancing PBM transparency. Julie shares the highlights of Judi Group's submitted comments and explains how the Department could help reshape the healthcare landscape, improve fiduciary practices, and drive systemic change in the pharmacy benefits ecosystem - but it shouldn't stop there.Julie dives into the arguments for and against the proposed rules, highlighting the importance of transparency in PBM compensation and the need for plan sponsors to understand the true costs associated with their health plans. She also discusses the potential impact of these regulations on reporting, which should get easier over time, and the medical side of drug spending, which is projected to outpace PBM-side drug spending in the near future. Julie's expertise and passion for improving fiduciary management make this episode a must-listen for anyone navigating the evolving worlds of healthcare policy and benefits.HighlightsJulie explains why the DOL's proposed rules are a critical step toward improving PBM transparency and enabling plan sponsors to make informed decisions.She emphasizes the need for clear disclosures on rebates, clawbacks, and indirect compensation to help plans verify reasonable compensation and minimize litigation risks.The discussion explores the growing importance of addressing medical-side drug spending, which could surpass PBM-side spending within the next five years.Julie shares insights on how machine-readable file disclosures could simplify compliance and create pricing benchmarks, enabling plan sponsors to evaluate whether costs are reasonable.State laws, the CAA 2026, these DOL proposed rules, and the recent FTC settlements all reinforce one another.Related Content & ResourcesFact Sheet: Proposed Pharmacy Benefit Manager Fee Disclosure RuleJudi Health Partner Summit Highlights: Progress is Impossible to IgnoreAH102 - PBM Reform Update: Health Policy Changes Slowly, Until it Doesn't, with Lloyd FioriniClick HERE for more information on Judi Group.Get in touch with Julie on LinkedIn.For more information about this episode, please visit Judi Health - Insights.