Newsletters

09.26.24

FTC Sues PBMs Over Insulin Pricing, While Express Scripts Sues Commission Over PBM Interim Report

On September 20, the Federal Trade Commission (FTC) filed its first administrative complaint against PBMs under Chair Lina Khan, alleging "anticompetitive and unfair rebating practices” by the three largest PBMs that have inflated insulin prices.


09.19.24

Health AI Current “State” - All Eyes on California

Two bills specifically focus on health care and would impose requirements on use of AI by health care providers—including health facilities, clinics, physicians’ offices, or group practices —and health plans, respectively.


09.18.24

Senate HELP Committee Examines Impact of Private Equity on Steward Health Care

On September 12, the Senate HELP Committee held a hearing that examined the bankruptcy of Steward Health Care, a nationwide health system that includes more than 30 hospitals in eight states.


09.18.24

House Passes BIOSECURE Act

As part of the House’s “China Week”—focusing on legislation to curb threats from Beijing—the House passed the BIOSECURE Act (H.R. 8333) on September 9 with strong bipartisan support (in a 306–81 vote).


09.18.24

Biden Administration Finalizes Mental Health Parity Rules and Priorities

On September 9, the U.S. Departments of Labor, Health and Human Services, and the Treasury (collectively, the Departments) released a final rule to strengthen implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA) (the Final Rule).


09.17.24

Community Reinvestment: Forging New Partnerships in Medicaid

State Medicaid agencies are increasingly implementing community reinvestment requirements in their contracts with Medicaid managed care organizations (MCOs) which require that MCOs reinvest in the communities they serve to improve health, often based on a percentage of their profits.


09.17.24

Unhealthy Alliance: Hospitals Sharing Senior Leadership Increases Antitrust Risk

Collusion among rivals has long been considered the “supreme evil of antitrust.” It is not surprising, therefore, that antitrust scrutiny was applied to one hospital’s decision to employ the Chief Executive Officer of its only competing hospital while the CEO still remained ...


09.12.24

CMMI Transforming Maternal Health (TMaH) Model Applications Due Soon

On June 26, the Centers for Medicare & Medicaid Services (CMS) released the Notice of Funding Opportunity (NOFO) for the Transforming Maternal Health (TMaH) Model.


09.11.24

Government Will Seek Supreme Court Review of Preventive Services Decision

On August 27, the government filed a motion indicating that it intends to seek Supreme Court review of the U.S. Court of Appeals for the Fifth Circuit’s decision in Braidwood Management v. Becerra.


09.11.24

Johnson & Johnson Announces Rebate Model for Certain 340B Drugs; HRSA Pushes Back

On August 23, Johnson & Johnson (J&J) issued a written notice to disproportionate share hospitals that participate in the prescription drug discount program established under section 340B of the federal Public Health Service Act, advising them that, beginning on October 15, it would no ...