SB 41 prohibits spread pricing, requires PBMs and group purchasing organizations to pass through 100% of manufacturer rebates to health plans. Signed into law by California Governor Gavin Newsom in ...

PBM transparency reforms aim to lower drug costs, but their impact on competition depends on how they affect smaller and ...

From our years of counseling clients on effective pharmacy benefit management (PBM) contracting – from procurement to contract execution – Wiley Rein knows that many Plans (health plans/plan ...

The recent dismissal of an employee-led class action lawsuit against Johnson & Johnson (J&J), which alleged mismanagement of the health plan's prescription drug benefit, might give health plan ...

Across the country, health systems are rethinking their reliance on legacy PBMs. Instead of outsourcing, more organizations are bringing PBM functions in-house to take back control, capture savings, ...

A plan sponsor’s fiduciary duty to be transparent in Pharmacy Benefit Manager contracts safeguards plan participants’ interests and mitigates the risk of litigation, regulatory penalties, and ...

In this Golden Age of government programs, the health plan industry has never had more exposure to the generally poor performance of pharmacy benefit managers (PBMs). Performance metrics in Medicare, ...