Quick Summary: CMS has decided to no longer exclude certain manufacturer-sponsored copay …
HHS Finalizes Payer Transparency Rules
Quick Summary: Beginning in 2022, insurers must post online machine-readable files that …
Rebate Rule: Is it Finally Happening?
Quick Summary: In November 2020, the Trump Administration released the final rule …
Rutledge vs PCMA: An Overview of the Supreme Court PBM Case
Quick Summary: A 2015 Arkansas law requires pharmacy benefit managers (PBMs) to …
CMS Finalizes Rule Permitting Copay Accumulator Adjustment Programs in 2021: What Does It Mean?
Quick Summary: CMS finalizes rule allowing plan sponsors to utilize a Copay …
Managed Care Payer Implications Associated with Asset Transfer
Within the pharmaceutical industry, it is common for a manufacturer to sell …
A Closer Look at Executive Order 13939: Lowering Prices for Patients by Eliminating Kickbacks to Middlemen
Quick Summary: Requires HHS to finalize the proposed rebate rule that was …
Proposed Changes to the Medicaid Drug Rebate Program: What Might That Mean for Value-Based Contracts?
Quick Summary: CMS proposes two potential rules for adjusting “best price” determinations …
CMS Launches Model to Lower Out-of-Pocket Expenses for Insulin
Quick Summary: Lowers Medicare beneficiaries’ out-of-pocket costs for a broad set of …
Review of the President’s Executive Order on Access to Affordable Life-saving Medications (EO 13937)
Quick Summary: Requires Federally Qualified Health Centers to provide 340B prices for …