Oregon House passes Bill 3226 regulating pharmacy benefit managers and services

In a significant move to regulate the pharmacy benefit management industry, the Oregon State Legislature has introduced House Bill 3226, aimed at enhancing oversight of organizations involved in prescription drug services. The bill, which was ordered by the House on April 7, 2025, seeks to ensure that pharmacy benefit managers (PBMs) adhere to existing laws, even when they operate through pharmacy services administrative organizations (PSAOs).

The primary purpose of House Bill 3226 is to clarify the legal obligations of individuals and entities that contract with pharmacies for reimbursement claims under health plans. Specifically, it mandates that anyone acting on behalf of pharmacies must comply with regulations governing PBMs and obtain the necessary licensing to conduct such business. This move is intended to increase transparency and accountability within the pharmacy sector, addressing concerns about the influence of PBMs on drug pricing and access to medications.

Key provisions of the bill include the requirement for PSAOs to register with the Department of Consumer and Business Services as third-party administrators, thereby subjecting them to regulatory scrutiny. The bill also outlines exemptions from this registration requirement, which could impact smaller organizations in the industry.

Debate surrounding House Bill 3226 has highlighted the ongoing tensions between healthcare providers and PBMs. Proponents argue that the bill is a crucial step toward protecting consumers from potential abuses in the prescription drug market, while opponents express concerns about the regulatory burden it may impose on smaller pharmacies and PSAOs. Some stakeholders fear that increased regulation could lead to higher operational costs, which may ultimately be passed on to consumers.

The implications of this legislation are far-reaching. By tightening regulations on PBMs and PSAOs, House Bill 3226 aims to foster a more equitable healthcare environment in Oregon, potentially lowering prescription drug costs and improving access for patients. However, the bill's success will depend on its implementation and the willingness of the industry to adapt to new regulatory frameworks.

As the legislative session progresses, the bill's supporters will likely continue to advocate for its passage, emphasizing the need for reform in the pharmacy benefit management landscape. Meanwhile, stakeholders will be closely monitoring the discussions and potential amendments that could shape the final version of the bill. The outcome of House Bill 3226 could set a precedent for similar legislative efforts in other states, reflecting a growing national conversation about the role of PBMs in healthcare.