The Centers for Medicare and Medicaid Services is taking aim at pharmacy benefit manager spread pricing practices that it says results in an upcharge to Medicaid and CHIP managed care plans and higher ...

The Consolidated Appropriations Act of 2026 gives CMS more leverage to intercept when pharmacy benefit managers are driving up prices in Medicare Part D, explains Jesse Dresser, Esq.

The Biden administration has fired a warning shot against health insurers and pharmacy benefit managers over business practices that could threaten the financial health of pharmacies, as independent ...

Pharmacy leaders should watch Medicare MFP as it changes Part D drug pricing and introduces new reconciliation challenges for health systems.

Several pharmacy groups commended CMS for issuing a final rule eliminating Part D plans’ and PBMs’ use of DIR fees beginning Jan. 1, 2024, but indicated that more actions are needed to address PBMs’ ...

WASHINGTON The Centers for Medicare & Medicaid Services today issued a revised definition of multiple-source drugs to be reimbursed under its new payment formula for Medicaid prescriptions, even while ...

In the last month, CMS has announced several policy changes related to drug costs, COVID-19 and more that affect pharmacy operations. CMS is limiting out-of-pocket insulin costs for Medicare ...

CMS on Friday finalized a rule it estimates will save the federal government $75.4 million over the next decade in Medicare Advantage and Part D payments, with the agency crediting cost-savings to ...

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