The pressure to regulate the pharmacy benefit manager (PBM) industry is mounting.

As with many benefits-related reform movements, the push is found mostly at the state level. Most recently, the New York Assembly introduced a bill (A6341) to regulate PBMs.

Supporters of the bill say that the PBM industry is a multi-billion dollar business yet it’s one of the few areas of health care that operates with few regulations. As a result, many PBM practices are kept secret even from their clients with prescription plans.

There have been accusations of PBMs paying pharmacies one price, billing plan sponsers for a higher price and then pocketing the difference – even though the PBM is supposed to make its money by administering drug benefits (and keeping costs down) for the plan sponsor.

One of the nation’s biggest PBMs, CVS Caremark was the subject of a scathing investigation. The PBM vehemently denies the alleged wrongdoings.