{"id":145381,"date":"2026-03-12T10:34:18","date_gmt":"2026-03-12T14:34:18","guid":{"rendered":"https:\/\/medcitynews.com\/?p=145381"},"modified":"2026-03-13T03:24:43","modified_gmt":"2026-03-13T07:24:43","slug":"debunked-episode-24-pbm-reform-brainstorm-elevance-faces-cms-penalty-risk-his-hers-eucalyptus-deal-takeaways","status":"publish","type":"post","link":"https:\/\/medcitynews.com\/2026\/03\/debunked-episode-24-pbm-reform-brainstorm-elevance-faces-cms-penalty-risk-his-hers-eucalyptus-deal-takeaways\/","title":{"rendered":"Debunked Episode 24: PBM Reform Brainstorm, Elevance Faces CMS Penalty Risk, Hims &amp; Hers\u2019 Eucalyptus Deal Takeaways"},"content":{"rendered":"\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Elevance Health Halted: CMS Penalties and the $1.5B Eucalyptus Acquisition | DeBunked Episode 24\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/FBh42qzMozU?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p>In the latest episode of the Debunked Podcast, co-hosts MedCity News Editor-in-Chief Arundhati Parmar and Samir Batra, managing partner of Health Innovation Pitch, listed potential ways to reform pharmacy benefit managers. Samir also offered his views on a bipartisan bill from Senator Elizabeth Warren (D-MA) and Josh Hawley (R-MO) to mitigate the impact of consolidation on the healthcare industry.<\/p>\n\n\n\n<p>Other highlights of the discussion include the conflict between <a href=\"https:\/\/www.healthcaredive.com\/news\/elevance-medicare-advantage-sanctions-cms-suspend-enrollment\/813522\/\" target=\"_blank\" rel=\"noreferrer noopener\">Elevance Health and CMS<\/a>. <a href=\"https:\/\/www.cms.gov\/files\/document\/elevancehealthsanction02272026.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">For the past 7 years<\/a>, Elevance failed to submit data backing up its members\u2019 risk adjustment scores through the electronic system CMS provides. Instead, it has submitted the data on encrypted flash drives. If Elevance does not comply with CMS, it risks being suspended from adding new enrollments to Medicare Advantage plans. These members account for an estimated 5% to 6% of Elevance\u2019s revenue.<\/p>\n\n\n\n<p>Hims &amp; Hers&#8217; move to <a href=\"https:\/\/medcitynews.com\/2026\/02\/hims-hers-acquisition-eucalyptus\/\" target=\"_blank\" rel=\"noreferrer noopener\">acquire Eucalyptus in a $1.15 billion deal<\/a> led Arundhati and Samir to ponder how the deal could be leveraged by the business to make the companies a global brand.<\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>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.<\/p>\n","protected":false},"author":26067,"featured_media":145394,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"om_disable_all_campaigns":false,"featured_image_focal_point":[],"homepage_placement":"top","homepage_placements":{"top":false,"featured":true,"sidebar":false},"homepage_alternative_layout":false,"featured_categories":[57],"hide_from_feed":false,"footnotes":""},"categories":[156,63,117,150,57],"tags":[6762,49486,48266,53431,53480,40137],"class_list":["post-145381","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-consumer-employer","category-daily","category-health-tech","category-pharmacy","category-politics-channel","tag-cms","tag-debunked-podcast","tag-elevance-health","tag-eucalyptus","tag-his-hers","tag-pbms"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Debunked Episode 24: PBM Reform Brainstorm, Elevance Faces CMS Penalty Risk, Hims &amp; 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