CMS ‘Safe Harbor’ For Use Of Copay Accumulators In Private Insurance Challenged In Court
Patient groups ‘left with no choice’ but to challenge federal regulation allowing commercial payers to bar manufacturer assistance with drug costs from being counted toward deductibles and out-of-pocket spending caps.
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Generic Tiering Requirement, Enhanced Oversight On Chronic Meds Proposed For Marketplace Plans
Commercial health insurance plans governed by the Affordable Care Act would need to modify their formularies for 2024 with policies to avoid discriminatory coverage of four ‘chronic ... high-cost medical conditions’ as well as overpayment for generics, according to CMS proposals.
Copay Assistance Can Be Excluded From Medicaid ‘Best Price’ Without Strings Attached – US Court
Decision is a win for the Pharmaceutical Research and Manufacturers of America in lawsuit against the US Health and Human Services Department.
A Case For Transparency: J&J Suit Targets Opaque PBM Affiliate’s Efforts To Exploit Copay Programs
Lawsuit highlights the lack of transparency into pharmacy benefit manager activities and how their programs can influence drug pricing. A Senate hearing on PBMs held shows increasing momentum behind a Federal Trade Commission study on potential anti-competitive activity in the market sector.