A new bill signed by Tennessee Governor Bill Lee prohibits pharmacy benefit managers (PBMs) from simultaneously owning or operating pharmacies.
Lee signed the Freedom, Access and Integrity in Registered Pharmacy (FAIR Rx) Act into law on May 22.
A news announcement from the National Community Pharmacists Association (NCPA) noted PBMs and supporters “reportedly spent over $7 million and hired more than 60 additional lobbyists for their campaign opposing the legislation.”
On May 22, CVS Health filed a lawsuit in federal court to block the FAIR Rx Act, saying in a statement, “This unconstitutional law puts special interests and local politics ahead of patients, restricting their access to life-saving medications and undermining fair competition.”
CVS said the new law would force more than 130 of its pharmacies and 25 MinuteClinic retail clinics to close.
New bills introduced at the federal level
“Today marks a historic step forward for patients and pharmacists across Tennessee,” said Tennessee Pharmacists Association CEO Anthony Pudlo said in the NCPA’s announcement. “We’re grateful to Gov. Bill Lee, the general assembly, and our pharmacist and technician members for standing together to push back on PBMs, strengthen patient protections and uphold fair, community-focused health care.”
“An enormous conflict of interest exists when a giant corporate PBM or insurance plan owns and operates its own pharmacy,” said B. Douglas Hoey, pharmacist, MBA, CEO of the NCPA. “This legislation simply gives these health care giants a choice — you can be a PBM or you can be a pharmacy, but you can’t be both. The FAIR Rx Act provides structural change that strikes at the crux of that conflict. We applaud the governor and legislators for their courage, withstanding tremendous pressure from the PBM-insurer lobby to pass this bill and defend Tennessee’s patients, taxpayers and pharmacies.”
Arkansas Governor Sarah Huckabee Sanders signed a similar PBM ban into law in April 2025.
On the federal level, the Patients Before Monopolies Act — which the NCPA said “would force companies that own health insurers or pharmacy benefit managers to divest their pharmacy businesses within three years” — was introduced in the U.S. House of Representatives and the U.S. Senate on May 13.
“The giant corporate PBMs are trying to use smoke and mirrors to convince members of Congress and state legislators that there’s nothing wrong with their business practices. But we know better,” Hoey said in a May 13 NCPA press release. “They often steer patients away from competing pharmacies and into their chain location or their mail-order pharmacy — even if their steering has a detrimental effect on patients. They reimburse their own pharmacies higher amounts than they reimburse competing pharmacies for the same prescriptions, just one tactic that forces independent pharmacies to close and robs patients of access to care.
“PBMs have a choice — operate as a PBM or operate as a pharmacy, but you can’t have it both ways. Having both functions under one roof is a huge conflict of interest and drives up prescription drug prices.”
