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.
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.
MedCity News was at the Vive conference and spoke with executives who shared their insights for the healthcare industry.
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.
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.
The Trump administration can immediately take these two price transparency administrative actions to reduce costs and improve affordability.
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.
Zelis highlights how employers, payers, and consumers are integrating digital tools to manage healthcare costs.
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.
With federal PBM reform stalled, states like California are stepping up with laws like SB 41 to boost transparency and lower drug costs.
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.
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.
Arbiter’s Anjali Jameson on hospital and payer alignment.
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 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.
A bill introduced by Rep. Earl L. "Buddy" Carter would ban PBMs’ use of spread pricing in Medicaid, among other reforms.
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.
UH Group replaces its CEO, the payer's alleged nursing home practices, the future of pharmacy benefit managers, and the healthcare implications of the budget bill are part of the latest episode of the Debunked Podcast with MedCity News Editor-in-Chief Arundhati Parmar and Samir Batra, managing partner of Health Innovation Pitch.