News & Analysis as of

Pharmacy Benefit Manager (PBM)

Akin Gump Strauss Hauer & Feld LLP

The Trump Administration Turns to Drug Pricing: Key Actions and Timelines Under the New EO

On April 15, 2025, President Donald Trump signed an Executive Order (EO) titled, “Lowering Drug Prices by Once Again Putting Americans First,” building on drug pricing related actions from his first term, President Biden era...more

Maynard Nexsen

JPMorgan Sued Over Management of Prescription Drug Benefits

Maynard Nexsen on

On March 13, 2025, several current and former participants in the JPMorgan Chase Health Care and Insurance Program for Active Employees, as well as its component Medical Plan (collectively referred to as the “Plan”) filed a...more

Maynard Nexsen

Prescription Revolution: Trump’s Bold Move to Slash Drug Prices

Maynard Nexsen on

An Overview of the Executive Order on Lowering Drug Prices - On April 15, 2025, President Donald J. Trump signed an Executive Order aimed at reducing prescription drug prices in the United States. This order builds upon...more

Hogan Lovells

White House issues Executive Order directing efforts to lower drug prices

Hogan Lovells on

On April 15, 2025, the White House issued an Executive Order (EO) entitled “Lowering Drug Prices by Once Again Putting Americans First.” The EO directs various agencies to engage in a number of distinct efforts to lower...more

Lathrop GPM

Call for Additional Regulations for Health Plan Compensation Disclosures

Lathrop GPM on

In an April 15 Executive Order, entitled “Lowering Drug Prices by Once Again Putting Americans First,” the Trump Administration has called attention to an ERISA disclosure required by the Consolidated Appropriations Act of...more

Bass, Berry & Sims PLC

Healthcare Trends & Transactions Q1 2025

Bass, Berry & Sims PLC on

The healthcare mergers and acquisitions (M&A) market began 2025 with a slower start than expected given the easing headwinds and building momentum at the end of last year, with the number of deals reported in Q1 lower than...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - April 2025 #2

News Briefs - Judge Blocks Trump from Cutting Billions in State Health Funding - A federal judge said she will grant a request from 23 states to issue an emergency block on the federal government's rescindment of billions in...more

DLA Piper

Keeping Watch on the Inflation Reduction Act: Medicare Poses Part D Formulary Access Challenges

DLA Piper on

Key points include access to medicines in medicare is reduced as the IRA is implemented; fewer drugs are covered on Medicare Part D formularies in 2025 relative to 2024; medicines for serious conditions with high unmet needs...more

Axinn, Veltrop & Harkrider LLP

Axinn Associates at the Antitrust Spring Meeting: Pharma Under the Antitrust Microscope

The Spring Meeting is the largest gathering of competition, consumer protection, and data privacy profes­sionals globally, with lawyers, academics, economists, enforcers, journalists, and students from around the world....more

Maynard Nexsen

2025 Alabama Legislative Update: Regular Session - Week Eight

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Farm Bureau Health Plan - On Thursday, comprehensive legislation, sponsored by Representative David Faulkner, proposing the creation of a new type of "health plan" that would be exempt from most state and federal laws and...more

Holland & Knight LLP

Excessive Fee Cases: Not Just for Retirement Plans Anymore

Holland & Knight LLP on

A recent wave of cases has attempted to apply the theory of liability for retirement plan excessive fee cases to health plans – specifically, arrangements with pharmacy benefit managers. Though the cases thus far have...more

Holland & Knight LLP

Holland & Knight Health Dose: April 8, 2025

Holland & Knight LLP on

Looking Ahead: House to Vote on Compromise Budget Resolution On the heels of the U.S. Senate's passage of a compromise budget resolution, the U.S. House of Representatives is expected to consider the budget resolution on the...more

Maynard Nexsen

2025 Alabama Legislative Update: Regular Session - Week Seven

Maynard Nexsen on

Pharmacy Legislation - This week, the House Insurance Committee gave a favorable report to legislation, sponsored by Senator Billy Beasley, concerning Pharmacy Benefit Managers (PBMs) and altering the mechanism by which...more

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - Legislative Day 39 - April 2025

Strike up the band! The penultimate day of the 2025 Legislative Session has come! Legislative Day 39 continues as this Gold Dome Report goes online, and Sine Die Eve has already proven to be a spectacle. From a marching band...more

Maynard Nexsen

2025 Alabama Legislative Update: Regular Session - Week Six

Maynard Nexsen on

Pharmacy Legislation This week, the Senate passed legislation, sponsored by Senator Billy Beasley, concerning pharmaceutical benefit managers (PBMs) and altering the mechanism in which independent pharmacists are reimbursed....more

Maynard Nexsen

The Alabama Community Pharmacy Relief Act: Key Provisions and Legislative Journey

Maynard Nexsen on

Introduction The Alabama Community Pharmacy Relief Act, Senate Bill 252, has successfully passed the Alabama Senate and is now advancing to the House for consideration. This legislation aims to regulate pharmacy benefits...more

Groom Law Group, Chartered

Plaintiffs Double Down on Challenges to PBM Arrangements in Class Action Lawsuits Involving Johnson & Johnson and JPMorganChase

On March 10, 2024, the plaintiffs filed an amended complaint in a much-followed putative class action lawsuit against Johnson & Johnson (“J&J”) alleging that the plan fiduciaries for J&J’s group health plan violated ERISA by...more

Keating Muething & Klekamp PLL

Benefits Monthly Minute - March 2025

The March Monthly Minute brings you three recent case updates addressing 401(k) forfeiture utilization, TPA responsibility for recovering self-insured plan’s fraudulently paid claims, and continued PBM litigation in the wake...more

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - Legislative Day 33 - March 2025

The Georgia House of Representatives achieved the trifecta on Thursday, combining three favorite legislative traditions in one moment on the floor: recognition of a local novelty with an invite resolution, the appearance of a...more

Wiley Rein LLP

[Podcast] Pharmacy Benefit Segmentation: Emerging Models for Health Plans

Wiley Rein LLP on

In this episode of The Wiley Contracting Chronicles, hosts Jordan Ross and Brooke DeLoatch discuss the growing trend of pharmacy benefit segmentation among health plans. They outline three emerging models identified at Wiley:...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - March 2025 #2

News Briefs - Analysts Predict Increase in 2025 P.E. Healthcare Dealmaking - Following a steady, but modest, year of private equity dealmaking in healthcare, 2025 could see higher levels of activity as market conditions...more

Holland & Knight LLP

Holland & Knight Health Dose: March 4, 2025

Holland & Knight LLP on

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

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - February 2025 #4

News Briefs - Healthcare Industry Prepares for Stricter FTC Merger Guidelines - The Federal Trade Commission will continue to use stricter guidelines inked by the Biden administration in reviewing corporate mergers, FTC Chair...more

Nelson Mullins Riley & Scarborough LLP

Gold Dome Report - Legislative Day 25 - February 2025

Amidst the usual suits and blazers, white dresses and tuxedos have been appearing with increasing frequency around the Georgia State Capitol this spring. Apparently word is out amongst the city’s photographers that the...more

McDermott+

McDermott+ Check-Up: February 28, 2025

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House Passes Budget Resolution. On February 25, the House voted 217 – 215 to advance its version of a budget resolution to outline the reconciliation process. In a dramatic display of how quickly things can change, the vote...more

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