Insights: Healthcare

340B Drug Discount Program

The White House Office of Management & Budget (OMB) is currently reviewing a proposed rule regarding the Health Resources and Services Administration’s (HRSA) 340B Rebate Pilot Program.

Democratic Drug Pricing Agenda

Democratic members of the Senate Finance Committee – including Ranking Member Wyden (D-OR) and Sens. Welch (D-VT), Cortez Masto (D-NV), and Gallego (D-AZ) – have released a high-level policy framework to lower drug prices.

ACA/PY27 Individual Market Regulations

The Centers for Medicare & Medicaid Services (CMS) issued the proposed “Notice of Benefit and Payment Parameters” for the plan year (PY) 2027. The rule sets standards for Affordable Care Act (ACA) coverage and the health insurance exchanges. Below is a high-level summary of the key attributes of the proposed rule that impact consumers, insurers,...

Drug Pricing/TrumpRx

The launch of the TrumpRx direct-to-consumer (DTC) platform has been delayed, though HHS Secretary Kennedy has indicated it could go live as soon as this month. There is speculation the delay is attributable to concerns relating to the Anti-Kickback Statute (AKS). To that end, in recent days, the HHS Office of Inspector General (OIG) issued a...

Medicare Drug Price Negotiations

CMS released the names of the 15 Parts B and D drugs subject to the third round of the Medicare drug price negotiation program established under the Inflation Reduction Act (IRA). Additionally, CMS announced the first drug already included in the program which will be subject to renegotiation.

Medicare Advance

CMS has released the PY27 Advance Notice for the Medicare Advantage (MA) Program (also known as the Part II proposed rule, which addresses payment issues). Under the proposal, CMS proposes to increase aggregate plan payments next year by a net 0.09% relative to PY26 levels (or +$700m over PY26).