Oz: CMS Drug Price Transparency Rule Coming Soon
- The Centers for Medicare & Medicaid Services (CMS) may introduce a new rule this year mandating greater disclosure of drug costs by healthcare companies.
- Oz, speaking at an event hosted by Transparency Rx, suggested the rule would target those not openly sharing actual drug costs.
- While Oz offered no specifics, his remarks hint at potential rulemaking compelling insurers and PBMs to reveal net drug prices, according to Matt Fiedler, a senior fellow at...
CMS is poised to introduce a new rule focused on drug price openness,a move that could reshape how healthcare costs are disclosed. This shift, as reported by News Directory 3, would require insurers and PBMs to reveal net drug prices. The article discusses potential impacts and the ongoing debate surrounding the effectiveness of such policies. With the government pushing for increased transparency, understand the implications of this new rule and how it aligns with current regulations, and how previous attempts at mandating the same have fared. Discover what’s next in the evolving landscape of drug pricing.
CMS Eyes New Rule on Drug Price Transparency
updated June 26, 2025
The Centers for Medicare & Medicaid Services (CMS) may introduce a new rule this year mandating greater disclosure of drug costs by healthcare companies. CMS Administrator Dr. Mehmet Oz said Tuesday the move aims to boost price transparency,a continuing priority.
Oz, speaking at an event hosted by Transparency Rx, suggested the rule would target those not openly sharing actual drug costs. Transparency Rx is a group of smaller pharmacy benefit managers (PBMs) advocating for more clear pricing practices.
While Oz offered no specifics, his remarks hint at potential rulemaking compelling insurers and PBMs to reveal net drug prices, according to Matt Fiedler, a senior fellow at the USC-Brookings Schaeffer Initiative for Health Policy. Net prices,reflecting savings negotiated by PBMs,are typically closely guarded.
A previous attempt to mandate public disclosure of net costs was thwarted by a lawsuit from the Pharmaceutical Care Management Association (PCMA), the largest PBM lobby. However, the Department of health and Human Services (HHS) is actively pursuing healthcare price transparency following an executive order.This could provide an prospect to revisit the issue with potentially stricter enforcement, given current low compliance among hospitals and payers.
Fiedler suggests regulators may seek firmer legal ground to enforce compliance,potentially requiring another rulemaking process.
Reviving Price Transparency Efforts
In May, the Trump administration issued a request for details (RFI) on improving prescription drug price transparency amid concerns about the concentrated and opaque pharmaceutical supply chain, dominated by CVS’ Caremark, Cigna’s express Scripts, and UnitedHealth’s Optum Rx.
The RFI sought input on building upon existing disclosure requirements. Oz said the RFI would provide insights into actual drug pricing, enabling the administration to push that information to clinicians and patients.
The Trump administration has long advocated for healthcare transparency, believing that price comparison empowers patients and lowers costs.in 2020, rules were finalized requiring hospitals to publish payer-specific rates and health plans to disclose in-network rates.
though, enforcement waned, leading to low compliance. As of November, only about 21% of hospitals share full pricing files online.
Original rules requiring health plans to publish past net prices were delayed after lawsuits, including one from the PCMA. The PBM lobby argued that disclosure would reduce drug discounts as pharmaceutical companies learned about competitors’ concessions.
Critics contend that PBMs resist transparency to protect their negotiating power and profits. Increased transparency could help employers and health plans choose the best PBM partners, fostering competition.
Fiedler notes that research on the overall impact of price transparency on drug costs is limited. he suspects the direct effects of disclosing this information may be modest.
the PCMA dropped its lawsuit in 2021 after the Biden administration allowed PBMs to report rebate information to the government without public disclosure.
The HHS,Labor,and Treasury departments stated in the May RFI that making cost information readily available would foster a more competitive,innovative,affordable,and higher-quality healthcare system.
Alongside the RFI, CMS updated hospital price transparency guidance, requiring actual dollar amounts for services whenever possible. The agency also directed payers to update rate reporting, including for prescription drugs.
The Trump administration plans to release a full blueprint for these changes in October, with enforcement slated to begin in February.
Oz Urges PBMs to Eliminate Rebates
Oz also expressed hope that PBMs would voluntarily become more transparent and reduce practices like retaining rebates instead of passing savings to clients.
“There’s a possibility that we have a window now where the three big PBMs might actually consider doing away with the rebate-slash-kickback system,” Oz said.
Oz cited a similar pledge from health insurers to reform prior authorization processes. Though, some remain skeptical that PBMs will take steps that could reduce their profits without government mandates.
ted Okon, executive director of the Community Oncology Alliance, suggested that any reduction in rebates would likely be offset by profits elsewhere in the pharmaceutical supply chain.
“It’s all whack-a-mole,” Okon said.
Fiedler agreed, stating, “I think it’s very unlikely rebates are going away. And if they go away, they’ll be replaced with some other type of discount that serves a similar function.”