News & Analysis as of

Employer Group Health Plans Healthcare Pharmacy Benefit Manager (PBM)

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

McAfee & Taft

Challenge to copay assistance strategy, another PBM ERISA preemption lawsuit, and other compliance issues for 2025

McAfee & Taft on

The end of 2024 gave group health plan sponsors several new lawsuits to watch in 2025. Gurwitch v. SAVE ON SP LLC - On December 26, 2024, a class action complaint was filed in the U.S. District Court for the Northern District...more

Wiley Rein LLP

PBM Contracting and Administration: What Are the Rules of the Road for Self-Insured Employees?

Wiley Rein LLP on

In February 2024, a group representing (among others) the Johnson & Johnson Group Health Plan and its component plans (Plaintiffs) sued Johnson & Johnson and The Pension & Benefits Committee of Johnson and Johnson (J&J) over...more

Snell & Wilmer

Five Facts About the Annual Gag Clause Prohibition Compliance Attestation

Snell & Wilmer on

Effective December 27, 2020, the Consolidated Appropriations Act, 2021 (“CAA”), as part of its transparency in health care protections, prohibits group health plans and issuers from entering into agreements that directly or...more

Mintz - Health Care Viewpoints

Senate HELP Committee Eyes Drug Pricing and PBM Regulation Beyond Federal Programs

On April 25, 2023, the Senate Health, Education, Labor, and Pensions Committee Chairman Bernie Sanders and Ranking Member Bill Cassidy introduced a package of legislation aimed at lowering prescription drug prices. The...more

Nilan Johnson Lewis PA

Health Plans, PBMs Now on the Clock as Minnesota Enacts New Law for Drug Pricing Transparency

On May 20, 2019, Minnesota Governor Tim Walz signed the Minnesota Pharmacy Benefit Manager Licensure and Regulation Act into law. This law aims to increase transparency regarding how drug prices are set and affords direct...more

Mintz - Health Care Viewpoints

Health Care Weekly Preview from ML Strategies – February 2019

The long-awaiting safe harbor proposed rule was published last week as the Administration looks to get out in front of the drug pricing debate that is sure to shape the 116th Congress. Under the proposed rule,rebates offered...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

New California Law Aims to Increase PBM Disclosure and Transparency

Employers looking for greater transparency on prescription drug pricing and pharmacy benefit manager (PBM) services will soon have a powerful new tool from an unlikely source: California lawmakers. Under Assembly Bill (AB)...more

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