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.
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.
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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.
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.
A Judge Approved BCBS’ $2.8B Settlement. Why Some Providers Are Opting Out
A judge has approved Blue Cross Blue Shield's $2.8 billion settlement with providers. However, some providers are opting out, arguing that it doesn't go far enough.
How Healthcare Leaders Are Responding to the Supreme Court’s Preventive Care Ruling
The Supreme Court upheld the constitutionality of an Affordable Care Act provision requiring insurance coverage of certain preventive services without cost-sharing. Many healthcare leaders applauded the decision, though some concerns remain.
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.
Beyond Analytics: How Sellers Dorsey is Hard-Coding Value into Medicaid Policy [Video]
How to turn analytics into actual policy outcomes.
How the Pending Supreme Court Decision on Preventive Care Could Affect the Healthcare Industry
The Supreme Court will soon hear oral arguments for a case that threatens coverage of preventive services without cost-sharing. Experts say this could make it significantly harder for patients to access care and lead to higher costs down the road.
Could the Trump Administration Change the Medicare Drug Price Negotiation Program?
CMS recently issued a statement saying that it's continuing the Medicare Drug Price Negotiation Program but is leaving the door open for potential changes. Experts weighed in on what changes could be made and what changes they would like to see.
The Big 3 PBMs are Countersuing the FTC. Does Their Argument Have Any Teeth?
After the FTC filed a lawsuit in September, accusing the three major pharmacy benefit managers of anticompetitive rebating practices related to insulin, the defendants reversed roles and became plaintiffs. In November, they countersued the agency, arguing that its lawsuit is unconstitutional.
The FTC Is Suing PBMs Over Insulin Prices. Will It Be Successful?
The Federal Trade Commission has sued CVS Caremark, Express Scripts and Optum Rx, alleging that they engage in "anticompetitive and unfair rebating practices” as it relates to insulin. One legal expert believes the FTC might win this legal battle.
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Inside an Automated Healthcare Practice: Redesigning Care Around People, Not Paperwork
By reducing administrative burden and redesigning workflows around human needs, it creates space for what matters most: connection between clinicians and patients.
A Federal Judge Struck Down FTC’s Ban on Noncompetes. What Does This Mean for Healthcare?
A federal judge recently blocked the FTC's ban on noncompetes. The decision has important implications for healthcare.