PBMs Urged to Strengthen Data Reporting and Transparency Amid Policy Shifts | PBMI 2025

As state and federal regulators push for greater transparency in pharmacy benefit management, PBMs are facing increasing demands for detailed reporting and adherence to a number of mandates. At the 2025 PBMI National Conference in Orlando, Joe Boyle, president of ClearFile, met with Managed Healthcare Executive to discuss how organizations can adapt to this increasingly complex policy environment.

Boyle said that PBMs should expect continued scrutiny over how they collect, manage and report data. State regulators, in particular, are asking for increasingly complex reporting that tends to go beyond what organizations are currently able to provide.

“I would advise PBMs to have dedicated staff for reporting, for data and analytics,” Boyle said.

He added that health plans should create a strong “pipeline of communication for states when they’re asking for more data,” because the volume and variety of requests are only expected to grow.

The policy environment is especially complicated at the state level, where each jurisdiction sets its own mandates, he expressed. For PBMs working across multiple states, this creates a list of reporting requirements that can strain operations and compliance resources. Boyle noted that the purpose and value of some of these requests are not always clear; however, organizations should still adapt quickly to avoid penalties.

Transparency remains a central theme.

With PBMs facing criticism from legislators, employers and advocacy groups, Boyle stressed that managing data and reporting can help rebuild trust. That means not only tracking mandates but also making sure systems are in place to share accurate information with regulators and other stakeholders.

Looking forward, Boyle advised PBMs to view transparency and reporting not just as compliance requirements but as strategic priorities that can shape how the industry evolves.

“If we think reporting is complex now, states will continue to ask for net new reports for arbitrary reasons, and we’re going to try to figure it out—why? What are they using the data for? And is it even valuable?” he said.

As PBMs face new regulations, those that invest in better data systems, clear communication and strong compliance will be more prepared to handle the pressure.