House Committee on Oversight and Government Reform Chair James Comer, R-Kentucky, has asked the pharmacy benefit managers commonly known as the industry’s “Big Three”—CVS Caremark, Optum Rx and Express Scripts—to turn over documents and communications about audits of independent pharmacies. Comer sent the letters on Oct. 23, 2026 to determine whether the firms issued what he described as punitive audits in response to those pharmacies’ public support for PBM reform.
Comer’s action follows reports from independent pharmacies that they experienced an “unusual surge in burdensome audits” after publicly backing the Pharmacists Fight Back in FEHB Plans Act (H.R. 6610), according to the committee’s announcement. The letters ask the companies for records that would shed light on the timing, targeting and scope of those audits.
In the letters, Comer sought documents, communications and staff-level briefings regarding each company’s audit processes. The committee asked for details on how pharmacies were selected for review, totals for national audits and any materials that explain audit timing and procedures. The letters also request specific audit records for independent pharmacies in Kentucky, Florida and Mississippi.
Comer highlighted examples the committee said raised red flags, including audits tied to prescriptions costing as little as 99 cents that nevertheless required “hundreds of hours of staff time” to address. The committee noted some audit notices listed compliance deadlines dated before the pharmacies had received the notices, and that audits included reviews of minuscule prescription charges.
The committee framed these findings as cause for concern that audit notices may have been sent or timed to retaliate against pharmacies for their support of H.R. 6610. Comer’s letters explicitly raise the prospect that audits were used as a response to legislative advocacy by independent pharmacies.
The inquiry is in keeping with Comer’s longer campaign to increase scrutiny of PBM behavior. The committee chair has been a vocal advocate for PBM reform since 2021 and spearheaded Oversight Committee activity on the topic in subsequent years.
The Oversight Committee previously released a 2024 report alleging that the industry’s largest PBMs had concentrated market power and used practices the committee said harmed community pharmacies. That report accused major PBMs of employing anticompetitive pricing strategies, according to the committee’s earlier findings.
Lawmakers carried several PBM-related reforms into the 2026 bipartisan funding package. Those provisions were aimed at increasing transparency into PBM activities, including measures affecting Medicare Part D. Comer’s latest letters tie directly into that push for greater visibility into PBM operations and their effects on pharmacies.
The announcement accompanying the letters describes a situation in which a pharmacy was audited over a medication that cost 99 cents. According to Comer’s account, complying with the audit request required an outsized investment of staff time for the pharmacy. The committee also said some audits contained compliance deadlines dated before the pharmacy had received the audit notice.
The source material does not provide additional examples, company responses or details on the volume of audits named in the inquiry beyond noting an “unusual surge” in notices after the committee’s July markup of H.R. 6610.
Comer’s letters ask for records that would help the committee determine whether the audit practices were routine compliance measures or whether they reflected retaliatory action. The documents requested include communications about audit targets and totals that could show whether independent pharmacies were being singled out.
The source does not report whether the PBMs have responded to Comer’s request or what timeline the committee has set for compliance. The committee’s announcement did not include information about any planned hearings or follow-up actions beyond the document requests.
Independent community pharmacies have been a focal point in ongoing debates over PBM conduct. Reform advocates and lawmakers have sought more transparency into PBM contracts and auditing practices, arguing those measures can affect pharmacy viability and patient access.
Comer’s inquiry underscores continued Congressional attention to PBM practices and signals legislative and oversight authorities are pursuing additional information on how audits are conducted and whether those processes are being applied fairly across pharmacy types.
The source article did not include statements or responses from CVS Caremark, Optum Rx or Express Scripts. It also did not specify the number of pharmacies audited, the exact timeframe for the alleged increase in audits beyond the period following the committee’s July markup of H.R. 6610, or any legal or enforcement actions resulting from the inquiry.
The committee’s document requests could produce material that clarifies whether the audits were standard compliance activities or targeted actions tied to pharmacies’ political support for PBM reform. The source does not report on next procedural steps, such as whether the committee will hold hearings, set deadlines for the PBMs’ responses, or take legislative action based on the documents it receives.
For now, Comer’s letters represent the latest move in a multi-year oversight effort focused on PBM reform and the relationship between benefit managers and community pharmacies.
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