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Pharmacy Benefit Manager (PBM) Pharmacies Pharmaceutical Industry

Latham & Watkins LLP

Healthcare Life Sciences Drug Pricing Digest - June 2025 #3

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Our Drug Pricing and Market Access team tracks recent developments in healthcare reform, the Medicaid Drug Rebate Program, the 340B Program, Medicare, and state law....more

Seyfarth Shaw LLP

States Seeking Remedies for the Rising Costs of Prescription Drugs

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As expected, the lawsuits have commenced following the enactment of the Arkansas legislation prohibiting pharmacy benefit managers (PBM’s) from owning or operating actual pharmacies within the state. Michigan has filed its...more

Quarles & Brady LLP

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

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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

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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

ArentFox Schiff

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

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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

Quarles & Brady LLP

Proposed Legislation Indicative of Continued Congressional Efforts to Expand PBM Oversight

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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

Sheppard Mullin Richter & Hampton LLP

Key Proposals from the CY 2026 Medicare Advantage and Part D Proposed Rule

On November 26, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released the contract year 2026 proposed rule for the Medicare Advantage (“MA”) program, Medicare Prescription Drug Benefit Program (“Part D”),...more

DLA Piper

New York issues extensive new pharmacy benefit manager regulations

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On November 27, 2024, the New York State Department of Financial Services (DFS) will be releasing new regulations governing pharmacy benefit managers (PBMs). Beginning with legislation in 2021, New York has been active in...more

Smart & Biggar

Evolving pharmacy landscape signals more stringent regulatory scrutiny of “patient steering”

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The pharmacy landscape has evolved considerably over the past year, shining a spotlight on pharmacy “patient steering”, the practice of directing patients to certain preferred pharmacies. Though Quebec has long required that...more

Proskauer Rose LLP

FTC Focus: How Scrutiny Of PBMs And Insulin May Play Out

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This article is part of a monthly column that considers the significance of recent Federal Trade Commission announcements about antitrust issues. In this installment, we discuss the FTC's complaint on PBMs' conduct around...more

Wiley Rein LLP

Finding Calm During the PBM Storm: What Health Plans Can Do As FTC Litigation Intensifies

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Tensions between the Federal Trade Commission (FTC) and pharmacy benefit managers (PBMs) continue to mount, bringing PBM practices and calls for reform back into the spotlight. On September 17, 2024, one of the largest PBMs,...more

Wiley Rein LLP

Understanding Pharmacy Benefit Managers: The PBM Landscape Explained

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In this episode of Wiley’s Health Care Contracting Chronicles, hosts Jordan Ross and Brooke DeLoach introduce the complex world of Pharmacy Benefit Managers (PBMs) and their pivotal role in the healthcare industry. They...more

Faegre Drinker Biddle & Reath LLP

Recent Legislative Developments Impacting Pharmacy Benefit Managers, Health Plans & More

As prescription drug costs remains a significant, and largely bipartisan, issue for state and federal legislators, we continue to see activity focused on pharmacy benefit managers (PBMs) as we approach the last quarter of...more

Brownstein Hyatt Farber Schreck

Emerging Class Action Litigation Trend Over Excessive PBM Fees

A new litigation trend is emerging regarding fiduciaries of health plans and their duties to prudently evaluate fees being charged by pharmacy benefit managers (“PBM”). Two Fortune 50 employers, Johnson & Johnson and Wells...more

Spilman Thomas & Battle, PLLC

The Health Record - Healthcare Law Insights, Issue 4, August 2024

Welcome to our fourth issue of The Health Record - our healthcare law insights e-newsletter. In this edition, we address a variety of topics including a recent SCOTUS ruling and the potential impact on CMS, issues of patient...more

Epstein Becker & Green

FTC Releases Controversial Interim Staff Report on PBMs’ Purported Impact on Drug Prices

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At an Open Commission Meeting on August 1, 2024, the Federal Trade Commission (FTC) presented a report prepared by its staff entitled Pharmacy Benefit Managers: The Powerful Middlemen Inflating Drug Costs and Squeezing Main...more

Hall Benefits Law

32 State AGs Urge Justices to Review 10th Circuit Ruling Concerning ERISA Preemption of State PBM Law

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​​​​​​​A bipartisan group of attorneys general from 31 states and the District of Columbia filed an amicus brief in support of a petition for certiorari by Oklahoma’s insurance commissioner to review a decision by the U.S....more

Woodruff Sawyer

[Webinar] 2024 Mid-Year Pharmacy Benefits Update - Evaluating the state of biosimilars, the GLP-1 boom and the rise of transparent...

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Join our 2024 Mid Year Pharmacy Benefits Update webinar for a comprehensive analysis of the current pharmacy landscape. This informative session will delve into key trends, including the evolving biosimilars market, the...more

Snell & Wilmer

Perplexed and the Fiduciary Committee – PBM Edition

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I read the Lewandowski v. Johnson & Johnson class action complaint and couldn’t help but wonder – are plans and participants doomed, or can employers take proactive steps to satisfy their fiduciary duties and potentially...more

Woodruff Sawyer

Reducing Pharmacy Benefits Costs with a PBM

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According to a survey of 150 large U.S. employers, the median percentage of healthcare dollars spent on pharmacy increased from 21% in 2021 to 24% in 2022, and is the fastest rising component of healthcare....more

Epstein Becker & Green

FTC Continues Investigation into PBM Practices

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In recent remarks prepared for delivery to the White House roundtable on pharmacy benefit managers (PBMs), Federal Trade Commission (FTC) Chair Lina Khan made clear that the FTC’s investigation into PBM practices continues....more

Quarles & Brady LLP

340B Developments in 2024 – Litigation and Legislation

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Although we are only two and a half months in, 2024 has already seen its fair share of impactful 340B developments on both the litigation and legislative fronts....more

Harris Beach Murtha PLLC

New York Proposes New Regulations of Pharmacy Benefit Managers

The New York State Department of Financial Services has issued draft proposed comprehensive regulations of Pharmacy Benefit Managers (PBMs) in an attempt to eliminate anti-competitive activity and control prescription drug...more

Troutman Pepper Locke

Navigating the Future of Pharmacy Law: Key Takeaways From the 2023 American Society of Pharmacy Law Conference

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Earlier this month, the American Society of Pharmacy Law hosted its annual conference in San Antonio, TX. This gathering of industry leaders provided a unique opportunity to delve into the ever-evolving landscape of pharmacy...more

Polsinelli

Florida Proposes New Pharmacy Benefit Manager Rules

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On September 18, 2023, the Florida Office of Insurance Regulation (“OIR”) published proposed rules to implement provisions of the Prescription Drug Reform Act (Florida Senate Bill 1550) governing Pharmacy Benefit Managers...more

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