Will Tennessee’s PBM Bill Face the Same Fate as Arkansas’ Law?
Tennessee lawmakers recently passed a bill banning PBMs from owning pharmacies in the state, though like a similar Arkansas law, it is expected to face legal challenges if enacted.
Debunked Episode 24: PBM Reform Brainstorm, Elevance Faces CMS Penalty Risk, Hims & Hers’ Eucalyptus Deal Takeaways
In the latest episode of the Debunked Podcast, the discussion revolved around the Break Up Big Medicine legislation to rein in healthcare giants and ways to introduce meaningful PBM reform.
The Hidden Administrative Tasks Draining Small Practices
Small practices play a critical role in healthcare delivery, but they cannot continue to absorb ever-increasing administrative demands without consequences.
It Took Years for Congress to Enact PBM Transparency, Delinking. What About Vertical Integration?
Experts say the bipartisan Break Up Big Medicine Act — aimed at breaking up vertically integrated healthcare companies — faces slim chances of passing despite recent PBM reforms.
Employers Celebrated PBM Reform. The Reality Is More Complicated
The Consolidated Appropriations Act of 2026 and the Department of Labor’s proposed rule implement major PBM reforms for employers, but don’t include everything they want, including a ban on spread pricing.
Coalition of Pharmacy Groups Urges Congress to Enact PBM Reform
A coalition of major pharmacy organizations urged Congressional leaders to enact long-stalled PBM reforms to curb anti-competitive practices, lower drug costs and stop accelerating pharmacy closures that are limiting patient access to care.
President Trump Can Act Now To Make Healthcare Affordable
The Trump administration can immediately take these two price transparency administrative actions to reduce costs and improve affordability.
The Power Behind Enterprise EHR Software for Large Healthcare Systems
Enterprise EHR boosts scalability, interoperability, and governance for large healthcare systems.
Senators Introduce Bipartisan Bill to Increase Oversight of PBMs
A bipartisan Senate bill would boost transparency and oversight of pharmacy benefit managers by changing how they’re paid, expanding reporting requirements and strengthening protections for pharmacies and taxpayers.
The Path to Fair PBM Competition
When control over prescription drug access rests with only a few players, the result is not just market imbalance — it is higher plan costs, increased financial pressures, and ultimately reduced affordability for patients.
California Signs PBM Law: As Federal PBM Regulation Lags, the States Step Up
With federal PBM reform stalled, states like California are stepping up with laws like SB 41 to boost transparency and lower drug costs.
How Employers Can Build an Effective GLP-1 Strategy
Here are five guidelines to help employers balance health outcomes and financial responsibility to ensure that GLP-1 coverage is effective, affordable, and aligned with improved health and workforce well-being for employees and their families.
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Survey on the Healthcare Financial Landscape Offers a Roadmap for Stakeholders
Zelis highlights how employers, payers, and consumers are integrating digital tools to manage healthcare costs.
New AMA Report Highlights Lack of Competition in PBM Market
In a new analysis, the American Medical Association detailed the lack of competition among pharmacy benefit managers and their high level of vertical integration with insurers.
White Bagging: A Prescription for Disruption in Care
White bagging not only creates significant uncompensated administrative burden and scheduling challenges for providers, but it also delays or limits access to necessary medication for patients.
CalPERS Selects CVS Caremark as PBM, Replacing OptumRx
CalPERS has entered into a five-year agreement with CVS Caremark, who will provide outpatient prescription drug benefits for about 587,000 members enrolled in basic or Medicare HMO or PPO plans.
New Bipartisan Bill from Rep. Carter Aims to Crack Down on PBMs
A bill introduced by Rep. Earl L. "Buddy" Carter would ban PBMs’ use of spread pricing in Medicaid, among other reforms.
Why CVS, Express Scripts Are Suing Over the Arkansas PBM Law
Arkansas became the first state to pass a law banning pharmacy benefit managers from owning pharmacies, aiming to curb their market power and reduce drug costs. But major PBMs like CVS and Express Scripts are suing, claiming the law is unconstitutional.