Articles and Blogs

PBM

Hall Render’s This Week in Washington – May 10, 2019

[05/10/19]

Posted on May 10, 2019 in Federal Advocacy

Published by: Hall Render

Addressing “Surprise” Medical Bills High Priority for Administration and Congress Yesterday, President Trump held an address at the White House where he emphasized that Congress should act to “hold insurance companies and hospitals totally accountable” for surprise medical bills. A surprise medical bill, more commonly known as balance billing, occurs when patients, through no... READ MORE

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Hall Render’s This Week in Washington – April 12, 2019

[04/12/19]

Posted on April 12, 2019 in Federal Advocacy

Published by: Hall Render

Congressional Leaders Discuss Health Care Priorities Congress’ top leaders, Senate Majority Leader Mitch McConnell (R-KY) and House Speaker Nancy Pelosi (D-CA), announced they are not embracing “Medicare for All” as a priority at the American Hospital Association’s annual Washington conference. Both leaders reinforced that each chamber will pursue largely separate health care agendas in... READ MORE

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CMS Proposes to Require Manufacturers to Disclose Drug Prices in TV Ads

[11/21/18]

Posted on November 21, 2018 in Health Law News

Published by: Hall Render

The Centers for Medicare & Medicaid Services (“CMS”) recently issued a proposed rule (“Proposed Rule”) that would require pharmaceutical manufacturers to disclose the list price for a typical course of treatment of prescription drugs and biologics covered by Medicare or Medicaid in direct-to-consumer television advertisements. This policy development comes just two months after the... READ MORE

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DOJ Approves Merger Between Cigna and Express Scripts, Paving the Way for Increased Vertical Integration Between Payers and PBMs

[10/04/18]

Posted on October 4, 2018 in Health Law News

Published by: Hall Render

On September 17, 2018, the U.S. Department of Justice (“DOJ”) approved the $52 billion vertical merger between health insurer Cigna Corp. (“Cigna”) and pharmacy benefit manager (“PBM”) Express Scripts. The Cigna-Express Scripts merger is just one in a string of recent health insurer/PBM acquisitions. For more on these transactions, click here. As the largest unaffiliated... READ MORE

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CMS Announces New Opioid Safety Measures for Part D Plan Sponsors: What Is Really Going On?

[05/23/18]

Posted on May 23, 2018 in Health Law News

Published by: Hall Render

The Centers for Medicare & Medicaid Services (“CMS”) recently finalized several new policies aimed at preventing and combating prescription opioid misuse by Medicare Part D beneficiaries. The policies, detailed in CMS’s 2019 Final Call Letter (“Call Letter”)[1] and outlined below, require Part D plan sponsors to implement various safety measures to reduce opioid overuse among... READ MORE

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The Wave of PBM and Insurer Integration Continues as Cigna and Express Scripts Announce a Merger of Their Own

[03/16/18]

Posted on March 16, 2018 in Health Law News

Published by: Hall Render

Last week, Cigna Corporation, the fifth largest health insurer in the country, and Express Scripts, the nation’s largest stand-alone pharmacy benefit manager (“PBM”), issued a statement outlining Cigna’s plans to acquire the PBM giant for $67 billion. This deal is just the latest example of a health insurer and PBM joining forces, coming just... READ MORE

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