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Byline: Kerry Dooley Young Medicare's drug benefit, known as Part D, will see major changes next year as part of a broader push to help the 50 million-plus Americans enrolled [...]

On November 26, 2024, Centers for Medicare & Medicaid Services ('CMS') released a proposed rule revising the Medicare Advantage ('MA') Program (Part C), Medicare Prescription Drug Benefit Program (Part D), [...]

On November 26, 2024, the US Centers for Medicare & Medicaid Services (CMS) released the Contract Year (CY) 2026 Policy and Technical Changes to the Medicare Advantage (MA) Program, Medicare [...]

Listen to this post California is poised to pass a ballot measure aimed at imposing 340B spending restrictions for certain healthcare entities participating in the 340B Program who have historically [...]

The pharmacy landscape has evolved considerably over the past year, shining a spotlight on pharmacy 'patient steering', the practice of directing patients to certain preferred pharmacies. Though Quebec has long [...]

This article is part of a monthly column that considers the significance of recent Federal Trade Commission announcements about antitrust issues. In this installment, we discuss the FTC's complaint on [...]

Byline: Julia Maruca Jul. 11A bill placing regulations on pharmacy benefit managers is headed to Pennsylvania Gov. Josh Shapiro's desk. The bill, which began in the state House, passed overwhelmingly [...]

Byline: Julia Maruca Jul. 10A bill placing regulations on pharmacy benefit managers third-­party intermediaries who work with drug manufacturers, pharmacies and insurance providers passed overwhelmingly in the Pennsylvania Senate on [...]

The Centers for Medicare & Medicaid Services (CMS) updated its guidance on the Inflation Reduction Act of 2022's (P.L. 117-169) (IRA) Medicare Prescription Payment Plan (M3P) with its release of [...]

On May 8, 2024, the U.S. House of Representatives Ways & Means Committee passed a bipartisan bill entitled the 'Preserving Telehealth, Hospital and Ambulance Access Act' by a vote of [...]

On May 11, 2023, the Senate Health, Education, Labor and Pensions (HELP) Committee voted to favorably report a bill limiting what pharmacy benefit managers (PBMs) can charge for drugs, as [...]

Highlights Florida's Prescription Drug Reform Act, recently signed into law by Gov. Ron DeSantis, has created a robust regulatory framework intended to address several key issues with respect to pharmacy [...]

BALTIMORE, MD -- The following information was released by the Centers for Medicare & Medicaid Services (CMS): Background On April 5, 2023, the Centers for Medicare and Medicaid Services (CMS) [...]

Though many recent reforms regarding prescription drug affordability have been focused on manufacturers and health plans, pharmacy benefit managers ('PBMs') are also the focus of increased attention from federal policymakers [...]

Byline: David Moscrop In Canada, the governing Liberal Party and the opposition New Democratic Party have struck a deal aimed at keeping the government in power until 2025. Under the [...]

Litigation involving drug price reporting under the Medicaid Drug Rebate Program (MDRP)1 has been very active in 2022. Most recently, on August 3, 2022, an Illinois federal jury levied a [...]

As we noted in our last PBM Regulatory Roundup, there has been a wave of state regulation focused on PBM practices in the wake of Rutledge and Webhi. However, PBMs [...]

The U.S. Supreme Court sided with medical providers on June 15, 2022, after the U.S. Department of Health and Human Services (HHS) cut Medicare Part B reimbursements to healthcare providers [...]

Key Points: The Supreme Court invalidated 2018 and 2019 cuts to Medicare reimbursement rates for hospital outpatient drugs acquired through the 340B Drug Pricing Program, effectively reinstating the default rate [...]

On May 11, 2022, New York Governor Kathy Hochul announced the creation of the Department of Financial Services' Pharmacy Benefits Bureau. Governor Hochul noted that the Pharmacy Benefits Bureau is [...]

On April 7, the Centers for Medicare & Medicaid Services (CMS) released its highly anticipated final National Coverage Determination (NCD) for Aduhelm and other similar therapies in the pipeline for [...]

In an effort to counteract rising prescription drug costs and health insurance premiums, New York Governor Hochul signed S3762/A1396 (the Act) on December 31, 2021. This legislation specifies the registration, [...]

The Big Picture On January 12, the Centers for Medicare & Medicaid Services (CMS) released the Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription [...]

The next post in our series analyzing the recently proposed Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs rule (Proposed Rule) [...]

On January 6, 2022, the Centers for Medicare and Medicaid Services ('CMS') issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare [...]

WASHINGTON -- The following information was released by the Congressional Budget Office (CBO): Part D is Medicare's optional prescription drug benefit. Medicare beneficiaries obtain coverage from private insurers, either through [...]

As a follow-up to our previous post, below is a list of fifteen New Jersey Statutes that either have been approved by the Governor or await the Governor's approval. New [...]