News & Analysis as of

Pharmacy Benefit Manager (PBM)

Groom Law Group, Chartered

Drug Pricing and Plan Contracting Practices Under Scrutiny: PBM and TPA Reforms in the Consolidated Appropriations Act, 2026

On February 3, 2026, Congress passed and the President signed the Consolidated Appropriations Act, 2026 (“CAA 26”), a legislative package that funds several federal agencies, including the Departments of Labor and Health and...more

McDermott+

Key takeaways: Health-related provisions in the FY 2026 minibus

McDermott+ on

On February 3, 2026, a comprehensive fiscal year (FY) 2026 appropriations package advanced through the US House of Representatives, finishing the legislative process for five of the six remaining appropriations bills....more

Cozen O'Connor

AG Bird Sues PBMs and Insulin Manufacturers over Alleged Pricing Scheme

Cozen O'Connor on

Iowa AG Brenna Bird filed a lawsuit against multiple pharmacy benefit managers (PBMs) and insulin manufacturers, alleging the companies violated Iowa’s Consumer Fraud Act by artificially inflating diabetes drug prices for...more

Brownstein Hyatt Farber Schreck

Labor-HHS Fiscal Year 2026 Appropriations Bill and Health Care Extenders Overview

Congress enacted the fiscal year 2026 Labor, Health and Human Services, Education, and Related Agencies (LHHS) appropriations bill, providing roughly $221 billion in total funding across the subcommittee’s jurisdiction,...more

McDermott+

PBM reform: The intersection of legislation and regulations

McDermott+ on

Often in the policy realm (and especially in the health space), major reforms are tackled in both the legislative and regulatory arenas. Congress may enact standalone policies that regulators are required to implement, or...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - January 2026 #4

News Briefs - House Passes Funding Bill Extending Telehealth, Hospital-at-Home - The House passed the Department of Health and Human Services' funding bill, including the telehealth and hospital-at-home extensions. Under the...more

Akin Gump Strauss Hauer & Feld LLP

PBM Reform Picks Up Pace with Enactment of Consolidated Appropriations Act, PBM Fee Disclosure Proposed Rule

Pharmacy benefit manager (PBM) reform has been an active and evolving area for policymakers in Washington, D.C. for many years but reform efforts have noticeably picked up pace in 2026. Recent actions by Congress and the...more

Troutman Pepper Locke

Virginia’s EpiPen Settlement and What It Signals for Pharma Under AG Scrutiny

Troutman Pepper Locke on

On January 16, Attorney General (AG) Jason Miyares’s last day in office, the Virginia AG reached a settlement with Viatris, Mylan’s corporate successor, over EpiPen pricing and related practices. The settlement was filed and...more

Venable LLP

HHS OIG Issues New Guidance on Direct-to-Consumer Prescription Drug Sales and Anti-Kickback Risk

Venable LLP on

On January 27, 2026, the U.S. Department of Health and Human Services Office of Inspector General (OIG) issued a Special Advisory Bulletin addressing how the federal Anti-Kickback Statute (AKS) applies to direct-to-consumer...more

Holland & Knight LLP

Holland & Knight Health Dose: February 3, 2026

Holland & Knight LLP on

The federal government has been in a partial shutdown since late last week, with several federal agencies – including the U.S. Department of Health and Human Services (HHS) – experiencing a lapse in appropriations. The U.S....more

Groom Law Group, Chartered

DOL Proposes Pharmacy Benefit Manager Fee Disclosure Rule

This is the first of several alerts that Groom Law Group expects to issue regarding the new proposed regulation issued on January 29, 2026 by the U.S. Department of Labor (“DOL”) requiring providers of pharmacy benefit...more

Foley & Lardner LLP

DOL Proposes Sweeping New Disclosure Rules for Pharmacy Benefit Managers

Foley & Lardner LLP on

On January 30, 2026, the Department of Labor’s (DOL) Employee Benefits Security Administration (EBSA) published proposed regulations (408(b) rules) that would significantly increase transparency requirements for pharmacy...more

McDermott+

McDermott+ Check-Up: January 30, 2026

McDermott+ on

Partial government shutdown seems likely. Senate Democrats, Republicans, and the White House are working to find a resolution to funding for the US Department of Homeland Security....more

Goodwin

Health Headlines: January 2026

Goodwin on

Your monthly Rx for private equity, regulatory and compliance, and digital health updates....more

Littler

Policy Week in Review – January 30, 2026

Littler on

NLRB Division of Advice Recommends Dismissal of Expansive Charges The National Labor Relations Board (NLRB) Division of Advice (“Advice”) released a series of memos that recommended dismissal of charges that appear to have...more

Troutman Pepper Locke

House Passes HR 7148, Advancing New PBM Transparency and Compensation Rules

Troutman Pepper Locke on

On January 22, the U.S. House of Representatives passed on a bipartisan basis HR 7148, the Consolidated Appropriations Act, 2026 (HR 7148). If it also wins passage in the Senate, the bill would, among other Trump...more

Holland & Knight LLP

Holland & Knight Health Dose: January 27, 2026

Holland & Knight LLP on

Passage of a multi-bill appropriations package now looks to potentially be in jeopardy, following events over the weekend in Minneapolis. U.S. Senate Minority Leader Chuck Schumer (D-N.Y.) issued a statement following a law...more

Krieg DeVault

Congress Advances Bipartisan Health Bill as Part of FY 2026 Funding Package

Krieg DeVault on

House and Senate appropriations leaders have reached a bipartisan, bicameral agreement to keep the federal government funded through fiscal year 2026 while advancing several long-anticipated health care policy changes....more

BakerHostetler

White House and Congress Turn Focus to Health Policy

BakerHostetler on

On Jan. 15, 2026, the White House released a fact sheet outlining healthcare priorities (the Fact Sheet) and calling on Congress to turn those priorities into law. Congress is also including a health policy package in...more

McDermott+

McDermott+ Check-Up: January 23, 2026

McDermott+ on

Congressional leaders release FY 2026 Labor-HHS minibus and health package. On January 20, 2026, congressional appropriators released the 2026 Consolidated Appropriations Act, working to ensure that government funding does...more

Brownstein Hyatt Farber Schreck

Diverging Paths on Health Care Affordability: Inside the White House and Congressional GOP Plans

Last week, a group of congressional Republicans and the White House released competing health care frameworks that outline different visions for advancing their respective policy priorities. Still, as the 2026 midterm...more

Wilson Sonsini Goodrich & Rosati

2026 Antitrust Year in Preview: Life Sciences and Healthcare

The life sciences and healthcare industries have remained a major focus for government enforcers in the Trump administration. Agencies have continued to closely examine medical device and pharmaceuticals markets with a strong...more

Holland & Knight LLP

Holland & Knight Health Dose: January 21, 2026

Holland & Knight LLP on

The U.S. Senate is out of session this week, and all action is expected to take place in the U.S. House of Representatives following the release of a package containing the final four appropriations bills. The text of the...more

Ankura

2025 – Pharmacy Benefit Management Regulatory Snapshot – Federal, State, and the Initiation of New Drug Pricing Concepts

Ankura on

Throughout 2025, Congress introduced several bills related to the pharmacy benefit management (PBM) industry. As with the 118th Congress in 2024 (see The Focus of Federal Proposals on Pharmacy Benefit Management – 118th...more

Bradley Arant Boult Cummings LLP

JP Morgan 2026: Strategic Healthcare Market Takeaways

Our team spent the week at the JP Morgan 2026 conference engaging with industry leaders, health system executives, and financial sponsors. The prevailing tone was constructively optimistic, with participants focused on...more

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