On April 15, 2025, President Trump issued an Executive Order instructing federal agencies to implement a variety of drug pricing reforms. The Executive Order addresses drug pricing from several different angles, including...more
On March 12, 2025, in one of the Trump Administration’s first actions with respect to the Center for Medicare and Medicaid Innovation (CMMI), CMMI announced that it would prematurely terminate four alternative payment model...more
3/20/2025
/ Alternative Payment Models (APM) ,
Biden Administration ,
Centers for Medicare & Medicaid Services (CMS) ,
CMMI ,
ESRD ,
Healthcare Reform ,
Medicaid ,
Medicare ,
MedPAC ,
Trump Administration ,
Value-Based Care
The PBM regulatory landscape is rapidly evolving 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 as they happen. Our team...more
2/12/2025
/ Compliance ,
Federal Trade Commission (FTC) ,
Final Rules ,
Health Insurance ,
Healthcare ,
Legislative Agendas ,
Medicaid ,
Medicare ,
Pharmacy Benefit Manager (PBM) ,
Proposed Rules ,
Regulatory Agenda ,
Regulatory Reform ,
Regulatory Requirements
On September 26, 2024, the Centers for Medicare & Medicaid Services (CMS) released a final rule implementing changes to the Medicaid Drug Rebate Program (MDRP). While not the focus of the agency’s rulemaking, stakeholders...more
On March 17, the same day we wrote about proposed legislation in Connecticut to cap drug price increases, Governor Charlie Baker of Massachusetts included a similar proposal in his proposed budget. Similar to the Connecticut...more
4/22/2022
/ Affordable Care Act ,
Drug Pricing ,
Governor Baker ,
Medicaid ,
Medicare ,
Medicare Part D ,
Penalties ,
Pharmacy Benefit Manager (PBM) ,
PHRMA ,
Price Inflation ,
Proposed Legislation ,
State Budgets
In early January, Idaho Governor Butch Otter signed an executive order (EO) directing the state’s Department of Insurance (DOI) to “seek creative options” to expand “access” to health insurance coverage for Idahoans. The EO...more
4/3/2018
/ 1115 Waivers ,
1332 Waiver ,
Affordable Care Act ,
Association Health Plans ,
Centers for Medicare & Medicaid Services (CMS) ,
Deregulation ,
Executive Orders ,
Health Insurance ,
Healthcare Reform ,
Legislative Agendas ,
Medicaid ,
Trump Administration