Madison Castle

Madison Castle

Mintz

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PBM Legislation in the Reconciliation Bill is Far From Sweeping PBM Reform

Over the past few years, Congress has attempted to pass “federal PBM reform.” Members of Congress have held numerous hearings related to PBMs and introduced numerous bills seeking to regulate PBMs (we regularly track these...more

5/29/2025  /  Centers for Medicare & Medicaid Services (CMS) , Drug Pricing , Medicaid , Medicare Part D , New Legislation , Pharmacy Benefit Manager (PBM) , Proposed Legislation , Regulatory Reform , Reporting Requirements , Transparency

Mintz IRA Update — Fourth Edition: Q1 2025

Mintz’s Pharmacy Benefits and PBM Contracting Practice is pleased to present the ‘Fourth Edition: Q1 2025’ of our Mintz IRA Update, a regular publication that delves into developments of the Inflation Reduction Act of 2022...more

2/14/2025  /  Drug Pricing , Inflation Reduction Act (IRA) , Medicare , Medicare Part D , Pharmaceutical Industry , Pharmacy Benefit Manager (PBM) , Prescription Drugs , Regulatory Agenda , Regulatory Requirements , Supply Chain

Mintz IRA Update — Operationalizing the Medicare Prescription Payment Plan and Medicare Inflation Rebate Program

In addition to the Part D Benefit Redesign, the IRA’s Medicare Prescription Payment Plan (MPPP) went into effect beginning January 1, 2025. The MPPP requires Part D Sponsors (PDPs) to allow Part D beneficiaries to pay for...more

2/14/2025  /  Centers for Medicare & Medicaid Services (CMS) , Drug Pricing , Final Rules , Inflation Reduction Act (IRA) , Medicare , Medicare Advantage , Medicare Part D , Prescription Drugs , Regulatory Requirements , Reporting Requirements

The Uncertain Landscape of Medicare Agent/Broker Compensation Rules

In the Proposed Medicare Advantage and Part D Rules for 2025, the Centers for Medicare & Medicaid Services (CMS) proposed significant changes to how Medicare Advantage organizations (MAOs) are allowed to contract with and...more

7/11/2024  /  Administrative Procedure Act , Agents , Brokers , Centers for Medicare & Medicaid Services (CMS) , Contract Terms , Fees , Medicare , Medicare Advantage , Medicare Advantage Organizations (MAOs) , Medicare Part D

Unpacking CMS’s 2025 DSNP Changes: Considerations for Medicare Advantage Organizations

As part of its 2025 Medicare Advantage and Part D Final Rule (the Final Rule), the Centers for Medicare & Medicaid Services (CMS) made a number of enrollment changes impacting dual eligible special needs plans (DSNPs). The...more

5/3/2024  /  Centers for Medicare & Medicaid Services (CMS) , Enrollment , Final Rules , Medicaid , Medicare Advantage , Medicare Advantage Organizations (MAOs) , Medicare Part D

CMS Releases Part Two of Guidance for the Inflation Reduction Act’s Medicare Prescription Payment Plan

On February 15, 2024, the Centers for Medicare and Medicaid Services (CMS) released the Medicare Prescription Payment Plan Draft Part Two Guidance (Part Two Guidance) as part of the Inflation Reduction Act’s (IRA) efforts to...more

2/27/2024  /  Centers for Medicare & Medicaid Services (CMS) , Inflation Reduction Act (IRA) , Medicare Part D , Out-of-Pocket Expenses
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