By Jake Velie, Chairman & CEO, National Integrative Health

The momentum toward pharmacy benefit manager transparency just got a significant boost. As reported by Allison Bell in BenefitsPro on July 17, 2026, DOL Secretary nominee Keith Sonderling told the Senate Health, Education, Labor and Pensions (HELP) Committee that drafting new PBM transparency regulations is a priority for the Department of Labor.¹ The full hearing is available on the Senate HELP Committee’s website for anyone who wants to hear it straight from the source.²

“That’s going to save billions and billions of dollars for health care plans, which is going to drive down the cost of health care plans,” Sonderling stated during the hearing. He added that employers have “never been armed with information about what they’re paying for” and that “for the first time, they’re going to have that information.”¹

This is exactly the fight we’ve been in for years at National Integrative Health.

Why This Matters to Employers Right Now

For too long, PBMs have operated behind a curtain of complexity, profiting from spread pricing, rebate retention, and opaque formulary steering that costs plan sponsors billions annually. Sonderling’s commitment to transparency validates what we at NIH have built our entire model around: giving employers real visibility and real options to reduce their prescription drug spend.

This isn’t a new fight at the federal level. The Consolidated Appropriations Act of 2021 first cracked open the door by requiring group health plans to report prescription drug cost data and mandating PBM disclosure of rebates and fees.³ The DOL’s Transparency in Coverage Final Rule further required machine-readable pricing files from plans.⁴ And earlier this year, new federal PBM transparency laws created a collision with the DOL’s draft regulations that were already in motion, slowing the rulemaking process.⁵

Sonderling, who was confirmed as deputy secretary of Labor in March 2025 and became acting secretary after Lori Chavez-DeRemer resigned in April 2026,⁶ has now made it clear these regulations are back on the front burner. His oversight of the Employee Benefits Security Administration (EBSA), the agency that writes and enforces ERISA health plan rules, gives him direct authority to make this happen.⁷

At National Integrative Health, we don’t rely on a single strategy or hope that regulation will eventually fix the system. We deploy a multi-lever approach to achieve the lowest net cost on every claim, for every member:⁸

1. 340B Pricing: Access to the lowest U.S. source pricing available across all 50 states
2. Biosimilars: Therapeutic equivalents delivering 60–80% savings over brand medications
3. 503B Manufacturer Direct Contracting: Direct relationships with 503B outsourcing facilities for compounded specialty medications at a fraction of brand pricing
4. Proprietary 50-State Infusion Network: Our nationwide site of administration network redirects infusion and injection therapies from high-cost hospital outpatient settings to lower-cost, clinically equivalent alternative sites of care, saving plans 40–60% per administration⁹
5. Variable Copay Programs: Direct-to-manufacturer programs for GLP-1s and specialty medications
6. Clinical Interventions: Therapeutic substitutions, patient assistance programs, and provider coordination
7. Clinical Trial Program Access: Connecting eligible members to manufacturer-sponsored clinical trials, providing access to cutting-edge therapies to patients and large savings to plans in qualifying circumstances

This multi-channel model means we’re never dependent on any single regulatory outcome. If one lever faces headwinds, we pivot to the next-best option for the plan and the patient.⁸

Transparency Is Necessary, But Not Sufficient

While I applaud the DOL’s direction, employers shouldn’t wait for regulations to take action. Bell’s reporting notes that new draft or final regulations “may not come out in the next few weeks,” and that the department’s efforts have been slowed by the intersection of new congressional PBM transparency laws and existing draft regulations.¹ ⁵ When Sen. Bill Cassidy asked about a timeline, the best Sonderling could offer was, “We are working very hard on it.”¹

The reality is this: transparency tells you where the problem is. You still need a solution. That’s where a managed services organization like NIH comes in. We sit on the same side of the table as the employer, armed with clinical expertise and pricing intelligence across multiple channels, to ensure every dollar spent on pharmacy benefits is optimized.⁸

The Bigger Picture

As Sonderling moves through his confirmation process, his oversight would extend to ERISA-governed health plans, ACA employer provisions, and any new PBM legislation.¹ ⁷ These are the very regulatory frameworks that shape how employers structure and manage their health benefits. Having a Labor Secretary who views PBM accountability as a core priority signals a meaningful shift.

Sonderling also expressed enthusiasm at the hearing for creating benefit solutions for gig workers, programs that could let multiple platforms contribute to a worker’s benefit account without triggering employee classification under the Fair Labor Standards Act.¹ This signals a DOL that’s thinking creatively about expanding access to benefits, not just regulating existing ones.

At National Integrative Health, we welcome any effort to bring sunlight into the prescription drug supply chain. Transparency paired with actionable, multi-lever solutions is how we drive real savings for employers and better outcomes for their members.

The information age is finally reaching pharmacy benefits. It’s about time.

Jake Velie is Chairman & CEO of National Integrative Health, a managed services organization headquartered in West Des Moines, Iowa, specializing in prescription drug cost optimization for employer health plans.

Footnotes

¹ Bell, Allison. “DOL Secretary Nominee Calls PBM Transparency a ‘Priority.'” BenefitsPro, July 17, 2026. https://www.benefitspro.com/2026/07/17/dol-secretary-nominee-calls-pbm-transparency-a-priority/

² U.S. Senate HELP Committee. “Nomination of Keith Sonderling to Be Secretary of Labor.” Hearing recording. https://www.help.senate.gov/hearings/nomination-of-keith-sonderling-to-be-secretary-of-labor

³ Consolidated Appropriations Act of 2021, Pub. L. No. 116-260, Division BB, Title II (Transparency provisions requiring PBM disclosure of rebates, fees, and prescription drug cost reporting by group health plans).

⁴ U.S. Department of Labor, Department of Health and Human Services, and Department of the Treasury. “Transparency in Coverage Final Rule,” 85 Fed. Reg. 72158 (Nov. 12, 2020).

⁵ Bell, Allison. “Brand-New Federal PBM Laws Fuel Fight Over DOL Transparency Regulations.” BenefitsPro, Feb. 4, 2026. https://www.benefitspro.com/2026/02/04/brand-new-federal-pbm-laws-fuel-fight-over-dol-transparency-regulations/

⁶ Bell, Allison. “DOL Secretary Resigns, New Acting Head Has Been Active on Benefits.” BenefitsPro, Apr. 21, 2026. https://www.benefitspro.com/2026/04/21/dol-secretary-resigns-new-acting-head-has-been-active-on-benefits/

⁷ U.S. Department of Labor, Employee Benefits Security Administration (EBSA). https://www.dol.gov/agencies/ebsa

⁸ National Integrative Health. “About Us.” https://www.nationalintegrativehealth.com/

⁹ Magellan Rx Management. “Medical Pharmacy Trend Report: Site of Care Optimization.” Research shows that shifting infusion administration from hospital outpatient departments to physician offices, home infusion, or ambulatory infusion centers can reduce per-administration costs by 40–60%. https://www.magellanrx.com/medical-pharmacy-trend-report/