News & Analysis as of

Pharmacy Benefit Manager (PBM) Healthcare

McDermott Will & Emery

PBMs Score a Win in Federal Court Against State Regulation

McDermott Will & Emery on

A recent federal court decision has the potential to tip the balance in an ongoing series of skirmishes over state regulation of pharmacy benefit managers (PBMs). In McKee Foods Corp. v. BFP Inc. d/b/a/ Thrifty Med Plus...more

Seyfarth Shaw LLP

Cutting Out the Middle Man

Seyfarth Shaw LLP on

Arkansas has become the first state in the nation to enact legislation, effective starting in 2026, prohibiting pharmacy benefit managers (PBM’s) from owning or operating actual pharmacies within the state. We take a look at...more

Sheppard Mullin Richter & Hampton LLP

State Antitrust Enforcement Roundup: New Laws; New Potential Legislation; and New (and Broader) Areas of Focus

The number of U.S. states implementing or considering new antitrust laws (or supplementing existing laws) targeting proposed transactions continues to grow. As detailed in our healthcare merger matrix, many states have...more

Wiley Rein LLP

[Podcast] Contracting for Success: Key Legal Considerations When Segmenting Pharmacy Benefit Programs

Wiley Rein LLP on

In this episode of The Wiley Contracting Chronicles, co-hosts Jordan Ross and Brooke DeLoatch take a deeper dive into program segmentation within pharmacy benefit programs. After outlining the concept in their previous...more

Quarles & Brady LLP

Arkansas Law Prohibits Pharmacy Benefit Managers from Obtaining or Holding Pharmacy Permits

Quarles & Brady LLP on

On April 16, 2025, Arkansas House Bill 1150 (the “Bill”) was signed by Governor Huckabee Sanders. The Bill will have substantial implications for pharmacy benefit managers (“PBMs”) and pharmacies across the country....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

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

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

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

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

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

McDermott+ on

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

ArentFox Schiff

Massachusetts Enacts Drug Pricing Legislation: Introducing PBM Licensure, Mandatory Cost Reporting, and Consumer Cost-Sharing...

ArentFox Schiff on

On January 8, Massachusetts Governor Maura Healy signed into law “An Act Relative To Pharmaceutical Access, Costs And Transparency.” The Act will have a profound impact on all parties involved in setting and applying drug...more

Cozen O'Connor

Illinois Insights Special Edition: 2025 Budget Address Recap

Cozen O'Connor on

On Wednesday, February 19, Governor J.B. Pritzker delivered his seventh annual Budget Address to a joint session of the General Assembly, where he unveiled his $55.2 billion FY26 Executive Budget - marking an approximately $2...more

Quarles & Brady LLP

Proposed Legislation Indicative of Continued Congressional Efforts to Expand PBM Oversight

Quarles & Brady LLP on

On December 11, 2024, a bill was introduced in the U.S. House of Representatives that, if enacted, would have substantial implications for pharmacy benefit managers (“PBMs”) and pharmacies across the country. Titled the...more

Mintz - Health Care Viewpoints

PBM Policy and Legislative Update — Winter 2025

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

Mintz - Health Care Viewpoints

Health Law Diagnosed – New Year's Gratitude

In the latest episode of Health Law Diagnosed, host Of Counsel Bridgette Keller invites the Mintz Health Law team to reflect on what they’re grateful for as they prepare for the year ahead....more

Fennemore

Regulatory Landscape of Insurance Claims Denial Practices and Suggestions for a Path Forward to a Sustainable Healthcare Future

Fennemore on

In the wake of the December 4, 2024 fatal shooting of UnitedHealthcare’s CEO Brian Thompson, questions were raised about insurance claim denial practices. Several news outlets noted that UnitedHealth Group’s profits have been...more

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - January 2025 #2

News Briefs - Hospitals Urged to Check for Accuracy as AI Use Increases -About 65 percent, or 1,696, of U.S. hospitals surveyed reported using artificial intelligence or predictive models integrated with their electronic...more

Axinn, Veltrop & Harkrider LLP

The Fate of the “Last Gasp” of the Biden FTC: Will Its Legacy Survive the Trump Administration?

In the days leading up to President Trump’s inauguration, the Biden FTC rushed to initiate major lawsuits and to tie a bow on various antitrust policy efforts. In a series of dissenting statements, the minority Republican...more

Mintz - Health Care Viewpoints

Massachusetts Aligns with National Trends and Enacts Sweeping Legislation to Regulate Pharmaceutical Benefit Managers

On the heels of a nationwide push to regulate pharmacy benefit managers (PBMs), Massachusetts enacted a landmark piece of legislation to increase transparency and oversight within the pharmaceutical supply chain, specifically...more

McCarter & English, LLP

FTC Issues PBM Report Signaling Consolidation Is Impacting Pharmaceutical Prices

At a public meeting held on January 15, 2025, the Federal Trade Commission (FTC) summarized the Second Interim Staff Report (Second Report) stemming from its investigation into pharmacy benefit managers (PBMs) and their...more

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