Medicaid, Pharmacy Benefit Manager (PBM)

New Health Information Technology Standards for Medicare Part D

Ankura on 9/16/2024

On June 17, 2024, the final rule for Medicare Part D introduced new health IT standards, mandating the adoption of NCPDP SCRIPT Standard version 2023011 by January 1, 2028, while the NCPDP Formulary and Benefit (F&B) Standard...more

CMS 2026 IRA Price Negotiations Results Likely to Create Upstream and Downstream Effects

Mintz - Health Care Viewpoints on 8/20/2024

On August 15, 2024, CMS announced the results of the first round of the negotiated prices between CMS and participating drug manufacturers for the 10 selected drugs under the Inflation Reduction Act’s (IRA) Medicare Drug...more

Investigations Newsletter: Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme

ArentFox Schiff on 6/17/2024

Chicago Laboratory Owner Charged with Defrauding Medicare in $60 Million COVID-19 Test Kit Scheme - The Chicago-based owner of two laboratories, Zoom Labs Inc. and Western Labs Co., has been charged with health care fraud...more

McDermottPlus Check-Up: April 17, 2024

McDermott+ on 4/18/2024

House Energy & Commerce Health Subcommittee Holds Hearing on Cybersecurity. During the hearing, there was bipartisan concern about UnitedHealth Group’s response to the Change Healthcare cyberattack and consensus around the...more

Healthcare Authority Newsletter - March 2024 #2

Arnall Golden Gregory LLP on 3/15/2024

News Briefs - U.S. to Accelerate Medicare Payments in Wake of Cyberattack - The U.S. government said it will accelerate Medicare and Medicaid payments to some hospitals hurt by a hack at insurer UnitedHealth's technology unit...more

President Biden Releases FY 2025 Budget: What’s NOT in It?

McDermott+ on 3/14/2024

Earlier this week, President Biden released his Fiscal Year (FY) 2025 President’s Budget. As a reminder, every year, the White House releases a budget that serves as its official funding request to Congress for the following...more

Holland & Knight Health Dose: March 5, 2024

Holland & Knight LLP on 3/7/2024

Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. ...more

Healthcare Preview for the Week of: January 16, 2024

McDermott+ on 1/17/2024

PARTIAL SNOW DAY, PARTIAL SHUT DOWN? Much of the federal government is closed today because of yesterday’s significant (for DC) and unexpected snowfall. However, part of the federal government is set to shut down this...more

Duck and Cover! Two New “Nuclear Verdicts” Put California Employers On Alert

Proskauer - California Employment Law on 12/20/2023

The Los Angeles Superior Court has bestowed some remarkable gifts upon plaintiffs this holiday season. Two juries have issued gigantic verdicts in favor of individual plaintiffs in separate employment lawsuits within the past...more

California Prohibits PBM Discriminatory Practices Against 340B Program Covered Entities and Contract Pharmacies

Hinshaw & Culbertson - Health Care on 12/15/2023

The 340B Drug Program requires pharmaceutical manufacturers participating in the Medicaid program to provide covered outpatient drugs at significantly reduced prices to certain health care organizations and programs, referred...more

Holland & Knight Health Dose: December 12, 2023

Holland & Knight LLP on 12/15/2023

Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more

The Lower Costs More Transparency Act of 2023

Quarles & Brady LLP on 12/15/2023

The Lower Costs More Transparency Act of 2023, passed by the House 320-71 on Monday, December 11, 2023, would institute new transparency and pricing rules on pharmacy benefit managers (PBMs) and hospitals. The bill would...more

Navigating the Future of Pharmacy Law: Key Takeaways From the 2023 American Society of Pharmacy Law Conference

Troutman Pepper on 12/1/2023

Earlier this month, the American Society of Pharmacy Law hosted its annual conference in San Antonio, TX. This gathering of industry leaders provided a unique opportunity to delve into the ever-evolving landscape of pharmacy...more

Holland & Knight Health Dose: October 3, 2023

Holland & Knight LLP on 10/4/2023

Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. ...more

Healthcare Preview for the Week of: September 18, 2023

McDermott+ on 9/19/2023

This week, the US House of Representatives is expected to vote on the Lower Costs, More Transparency Act (HR 5378). This bill incorporates bipartisan policy provisions that have advanced out of the three committees—House...more

[Webinar] The Legal, Regulatory and Market Trends Transforming Health Care - October 5th, 9:30 am - 10:30 am PT

Manatt, Phelps & Phillips, LLP on 9/15/2023

From the end of the COVID-19 public health emergency (PHE) to the overturning of Roe v. Wade to the skyrocketing growth of virtual care, multiple forces are converging to remap the health care landscape. In a new webinar,...more

Holland & Knight Health Dose: September 12, 2023

Holland & Knight LLP on 9/14/2023

Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector....more

Pharmacy Benefit Managers are on the Federal Government’s Radar: Senate, House, and Agency Proposals Seek to Increase PBM...

Mintz - Health Care Viewpoints on 6/16/2023

Bipartisan legislative activity related to pharmacy benefit manager (PBM) oversight is at an all-time high in both the House and Senate. As we noted last week, several bills that address PBM activities are moving through the...more

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