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Wiley Rein LLP

Contracting With PBMs: Critical High-Value Issues to Consider

Wiley Rein LLP on

Crafting a new pharmacy benefit manager (PBM) agreement may feel like an uphill battle when you do not have the time and resources to develop a highly customized contract. While it is often more beneficial to a health plan to...more

Mintz - Health Care Viewpoints

PBM Policy and Legislative Update - Winter 2024

Mintz - Health Care Viewpoints on

The PBM regulatory landscape continues to evolve rapidly at both federal and state levels, making it critical for our clients involved in the PBM space to stay apprised of developments in the industry. Our team actively...more

Foley & Lardner LLP

The Inflation Reduction Act of 2022: Medicare Drug Pricing Provisions Will Change the Health Care Industry

Foley & Lardner LLP on

President Biden has now signed into law the $700 billion Inflation Reduction Act of 2022, a package comprised of health care, climate change, and taxation policy reforms. It is a scaled-back version of the Build Back Better...more

Mintz - Health Care Viewpoints

CMS Releases 2019 MA and Part D Final Rules and Call Letter

Mintz - Health Care Viewpoints on

Earlier this week, CMS released both the Contract Year 2019 Final Rules for Medicare Advantage and Part D (Final Rules) and the 2019 Call Letter. CMS also released fact sheets for the Final Rule and the Call Letter. The Final...more

Mintz - ML Strategies

Health Care Update - November 2015

Mintz - ML Strategies on

Ways & Means Leadership Changes – Health Policy Implications Looming: As Congress pushes forward with a two-year budget deal, and new Speaker Paul Ryan begins his tenure as the top Republican in the House of...more

McDermott Will & Emery

Congress Take Step Toward Site-Neutral Medicare Payments in Bipartisan Budget Act of 2015

McDermott Will & Emery on

On October 28, 2015, the U.S. House of Representatives approved legislation that, if enacted, would, among other things, substantially alter how and how much Medicare pays for outpatient services furnished by hospitals. The...more

Baker Donelson

HRSA Issues Long-Awaited 340B Program Omnibus Guidance Proposal

Baker Donelson on

After much anticipation, the Health Resources and Services Administration (HRSA) late last week released its 340B Drug Pricing Program Omnibus Guidance Proposal (the Proposal). HRSA indicates that its goal in issuing the...more

Foley & Lardner LLP

State Medicaid Programs May Be Leaving Revenue From Drug Rebates on the Table

Foley & Lardner LLP on

The recent release of a New York State Office of the State Comptroller audit report serves as an example of state Medicaid programs that may not be maximizing their collection of revenue from drug rebates for Medicaid managed...more

Mintz - Health Care Viewpoints

OIG Issues Favorable Advisory Opinion Regarding Tiered Rebate Program

Mintz - Health Care Viewpoints on

Yesterday, the OIG issued a favorable advisory opinion regarding an ophthalmologic manufacturer’s (the “Requestor”) tiered rebate program (the “Proposed Arrangement”)....more

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