CMS recently published “Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs; etc,”, effectively ending the retroactive application of direct and indirect renumeration (DIR) fees by Prescription Benefit Managers (PBM’s). DIR fees will now be required to be included in the negotiated price the patient pays at the …
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The regulatory landscape across the United States changed dramatically Friday as Dobbs v. Jackson Women’s Health Organization overturned the nearly five-decade precedent set by Roe V. Wade. In Dobbs, the United State Supreme Court held that abortion is not a constitutional right and should instead be regulated at the discretion of the individual states. The decision was met …
Continue reading “Uncertainty Looms Following Supreme Court’s Overturning of Roe v. Wade”
Both federal and state authorities are increasing the scrutiny and regulation of Pharmacy Benefit Managers (“PBMs”). In the U.S. Senate, Senator Chuck Grassley (R – Iowa) and Senator Maria Cantwell (D – Washington) have sponsored the Pharmacy Benefit Manager Transparency Act of 2022. The bipartisan bill would empower the Federal Trade Commission to increase drug …
Continue reading “Scrutiny of PBMs Continue (And It’s About Time)…”
On June 7, 2022, in a unanimous 5-0 vote, The US Federal Trade Commission reversed a previous 2-2 deadlock vote that will result in the commissions probe of pharmacy benefit managers including the top six PBMs; CVS Caremark, Express Scripts, Inc. OptumRx, Inc., Humana Inc., Prime Therapeutics LLC and MedImpact Healthcare Systems, Inc. After the …