Senators Elizabeth Warren and Josh Hawley and Representatives Diana Harshbarger and Jake Auchincloss introduced the Patients Before Monopolies Act on Wednesday. It aims to prohibit the parent company of a PBM or insurer from owning a pharmacy business.
Two senators recently introduced a bill that seeks to regulate private equity firms’ involvement in the healthcare industry. If passed, the act would establish a criminal penalty of up to six years in prison for private equity executives whose business decisions result in a patient’s death.
As technology advances, AI-powered tools will increasingly reduce the administrative burdens on healthcare providers.
The Lower Costs, More Transparency Act has passed in the House with bipartisan support. The action is being applauded from several advocacy organizations.
This week, senators introduced a bipartisan bill that would make it a federal crime to assault hospital workers. Even though nearly 40 states have passed laws to intensify penalties for violent acts committed against healthcare personnel, there is currently no federal law protecting hospital employees from assault or intimidation.
The Medicaid Staffing Flexibility and Protection Act was introduced by Representative Earl L. “Buddy” Carter (R-Georgia) and Representative Neal Dunn (R-Florida). It would allow state Medicaid agencies to hire outside contractors to help with Medicaid redeterminations, as many agencies don’t have the workforce to handle the return to the redetermination process.
The Senate Finance Committee voted 26-1 to advance the Modernizing and Ensuring PBM Accountability Act. The bill has several provisions, including delinking PBM income from prescription drug prices under Medicare Part D and banning spread pricing in Medicaid.
The future looks bright for the integrated specialty pharmacy model – for health systems, providers, and most importantly, for patients.
The Senate Commerce Committee held a hearing Thursday, which discussed how the Pharmacy Benefit Manager Transparency Act would affect practices by pharmacy benefit managers, including clawbacks. Some questioned why PBMs are even necessary.
The bill, if enacted into law, will establish an electronic prior authorization process and require Medicare Advantage plans to report on their use of prior authorization and the rate of approvals or denials to CMS. It has 227 co-sponsors in the U.S. House, indicating strong support from both Republicans and Democrats.
As the use of technology proliferates during the Covid-19 pandemic, concerns rise about privacy and health data security. Congressional Democrats have proposed new legislation that would protect individuals' data rights amid the public health crisis.
Congress finally reached an agreement on a $900 billion stimulus package, which includes a ban on surprise medical billing. A previous, but very similar version of the bill, raised concerns among providers and payers.
Closing cancer health equity gaps require medical breakthroughs made possible by new funding approaches.
A bill introduced to the U.S. House of Representatives on Thursday would permanently lift site restrictions for Medicare patients to access telehealth. During the pandemic, several restrictions on where telehealth visits could be conducted and what services were eligible were temporarily lifted.