Category: PBMs and Payers

Iowa Set to Enact Nation’s 25th 340B Nondiscrimination Law

In Legislative, PBMs and Payers, StateApril 25, 2023489 Views

The Iowa Senate last week passed a 340B nondiscrimination bill 49-1, sending it to Gov. Kim Reynolds. The House passed it earlier 98-0.

The Iowa Senate last week passed a House-approved bill banning pharmacy benefit manager and payor discrimination against 340B covered entities and their contract pharmacies, including reimbursing the entities at a lower rate than non-340B providers.

The Senate voted 49-1 on

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New Mexico Governor Signs Bill Protecting 340B Providers from PBM and Payer Discrimination

In Legislative, PBMs and Payers, Providers, StateApril 13, 2023384 Views

Ted Slafsky

New Mexico Gov. Michelle Lujan Grisham (D) has signed a law to prevent PBMs and insurers from discriminating against 340B providers.

New Mexico Gov. Michelle Lujan Grisham (D) signed a law April 7 to prevent pharmacy benefit managers and insurers from discriminating against 340B providers. The bill includes language that prohibits payers from reimbursing 340B covered entities at a

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Two GOP Senators Raise Concerns About PBM’s Infringement on 340B Savings in Recent Hearing

In Federal, Legislative, PBMs and PayersApril 6, 2023598 Views

Tom Mirga

Jonathan Levitt pictured at Senate hearing

The 340B program "is completely frustrated" by pharmacy benefit managers, health care attorney Jonathan Levitt said during a during a Senate Finance Committee hearing on PBMs.

Two Republican U.S. senators expressed concerns about pharmacy benefit manager encroachment on 340B covered entity savings during a Senate Finance Committee hearing on PBMs last week.

“I often hear concerns from South Dakota hospitals and health centers when

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U.S. House Oversight Committee Launches PBM Investigation

In Federal, Legislative, PBMs and PayersMarch 9, 2023327 Views

Laura Gilcrest

A U.S. House committee is investigating “anticompetitive tactics” by Express Scripts, CVS Caremark, and OptumRx.

The U.S. House Committee on Oversight and Accountability last week launched an investigation into how “anticompetitive tactics” by the three largest pharmacy benefit managers—Express Scripts, CVS Caremark, and OptumRx—are driving up healthcare costs and hurting patient care within

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Oregon Bill Targets PBM Policies that Discriminate Against 340B Pharmacies

In Legislative, PBMs and Payers, StateJanuary 20, 2023298 Views

Laura Gilcrest

A bill in Oregon would prohibit discriminatory practices by PBMs and insurance plans against 340B pharmacies.

Oregon legislators have introduced a bill that would prohibit discriminatory practices by pharmacy benefit managers and insurance plans against 340B pharmacies, including reimbursing a 340B pharmacy less for prescription drugs compared with non-340B pharmacies.

If passed later this

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Court Upholds $23 Million Judgement Against CVS Caremark for Unfair Pharmacy Reimbursement

In Federal, Judicial, PBMs and PayersSeptember 22, 2022439 Views

Sarah True

CVS Caremark must pay AIDS Healthcare Foundation $23 million for Part D drug reimbursement that the PBM clawed back from AHF unfairly, a court says.

A federal district court in Arizona has upheld a $23 million arbitration award to the AIDS Healthcare Foundation (AHF) against pharmacy benefits manager (PBM) CVS Caremark for unfair drug reimbursement.

In its November 2019 lawsuit, AHF alleged that

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Vermont Passes Bill Enhancing 340B Anti-Discriminatory Protections but Measure Aimed at Drug Manufacturers Fails

In Legislative, PBMs and Payers, Pharma Industry, StateAugust 9, 2022284 Views

Sarah True

Vermont recently extended its prohibition on discrimination by PBMs against 340B entities but did not require drug manufacturers to provide 340B-priced drugs to contract pharmacies.

The state of Vermont has passed a bill extending its prohibition on discrimination by pharmacy benefit managers (PBMs) against 340B covered entities, which was originally passed in June 2021 as part of the state’s 2022 budget.

The

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Exclusive: 340B Entities Report Unannounced and Unexplained Claims Reversals Involving CVS and Blue Cross Blue Shield

In PBMs and PayersJune 22, 20221569 Views

Tom Mirga

Providers say claims have been reversed without notice or explanation for 340B-purchased drugs that CVS Specialty dispensed to BCBS FEP participants.

UPDATE Wednesday, June 22, 2022, 2:50 p.m. EDT—CVS Health issued this statement: “We do not comment on specific PBM client contract terms. Our clients are sophisticated purchasers, and we work closely with them to customize a benefit design

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