News & Analysis as of

Pharmacy Benefit Manager (PBM) Prescription Drugs Pharmacies

King & Spalding

District Court Orders CVS Caremark to Pay U.S. Government $95 Million

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On June 25, 2025, Chief Judge Mitchell S. Goldberg of the U.S. District Court for the Eastern District of Pennsylvania issued a ruling in the case of U.S. ex rel. Sarah Behnke v. CVS Caremark Corp. et al., ordering CVS...more

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

Goodwin

Health Headlines: June 2025

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Welcome to the seventh issue of Health Headlines, a newsletter created by lawyers in our Healthcare practice. Iowa Governor Kim Reynolds signed Senate File 383 into law, placing new restrictions on pharmacy benefit...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

Indiana Senate Bill 140 Signed into Law Imposing Reforms on Pharmacy Benefit Managers

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Indiana recently enacted significant new legislation that will impact how pharmacy benefit management services are provided in Indiana. Senate Bill 140 (SB 140), signed into law during the 2025 legislative session, imposes...more

Mintz - Health Care Viewpoints

Arkansas Law Takes Unprecedented Step to Prohibit PBM Ownership of Pharmacies

On April 16, 2025, Arkansas Governor Sarah Huckabee Sanders signed into law House Bill 1150, now Act 624 (the Act), making Arkansas the first state in the nation to prohibit pharmacy benefit managers (PBMs) from acquiring or...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

Maynard Nexsen

The Alabama Community Pharmacy Relief Act: Key Provisions and Legislative Journey

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Introduction The Alabama Community Pharmacy Relief Act, Senate Bill 252, has successfully passed the Alabama Senate and is now advancing to the House for consideration. This legislation aims to regulate pharmacy benefits...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

Harris Beach Murtha PLLC

New York Adopts PBM Rules to Protect Consumers, Independent Pharmacies

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The New York State Department of Financial Services (DFS) recently announced it has adopted Pharmacy Benefit Manager Market Conduct Regulations to promote patient access to prescription drugs and to protect independent...more

Goodwin

Express Scripts Sues FTC Over Report on Pharmacy Benefit Management Industry

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​​​​​​​On September 17, Express Scripts, Inc. (“Express Scripts”), one of the largest pharmacy benefit managers (PBMs) in the United States, brought suit against the Federal Trade Commission (“FTC”) over its July 2024 interim...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

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

Holland & Hart - The Benefits Dial

Hole in the Bottle… Employer Considerations After Another Lawsuit Against an Employer Health Plan

Last week, former Wells Fargo employees filed a class action lawsuit against Wells Fargo and its health plan fiduciaries alleging that Wells Fargo’s self-funded health plan violated ERISA by paying its pharmacy benefits...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

Arnall Golden Gregory LLP

Healthcare Authority Newsletter - March 2024 #2

News Briefs - U.S. to Accelerate Medicare Payments in Wake of Cyberattack - The U.S. government said it will accelerate Medicare and Medicaid payments to some hospitals hurt by a hack at insurer UnitedHealth's technology unit...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

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