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Sen. Elizabeth Warren, D-Mass., and Sen. Josh Hawley, R-Mo., are launching the fight in a world where federal PBM transparency mandates are now law.

"The alleged violations by MultiCare show a wanton disregard for ethics and the medical principle to do no harm," Washington Attorney General Nick Brown said in a statement.

The company said its 27,000 pharmacists will guide customers in applying the discounts and support related programs, including NovoCare enrollment and reduced pricing on fertility medications through the TrumpRx Fertility initiative.

The Health Information Sharing and Analysis Center identified 4,043 incidents across all sectors in the first half of 2025, followed by 4,860 incidents in the second half of the year.

Employers should make sure they know who's responsible for paying the PBM noncompliance penalties, a compliance attorney says.

In some states, researchers warn, more than 55% of adults could be obese.