Another coalition of congressional lawmakers has united to introduce a new version of the Delinking Revenue from Unfair Gouging Act (DRUG Act) bill. Rep. Marianne Miller-Meeks (R-Iowa) and co-sponsors from both parties introduced the bill, which could impact how pharmacy benefit managers (PBMs) are paid.
Miller-Meeks unsuccessfully introduced a previous version of the bill during the 118th Congress.
PBMs
Employee Benefits
Bipartisan Duo Introduces New Version of PBM Reporting Bill
By Anne Hall
Two lawmakers from opposite sides of the aisle have revived a version of the pharmacy benefit manager (PBM) reporting bill from the 118th Congress. That bill came close to passage last year but faced criticism from Elon Musk, who ultimately tanked the much larger bill in favor of an abbreviated spending package.
Rep. Erin Houchin (R-Indiana), and Rep. Joe Courtney…
How Plan Sponsors Can Mitigate Risk In PBM Contracts
By Anne Hall
By Anne Tyler Hall and Tim Kennedy (April 17, 2025)
For employers offering benefit plans, fiduciary responsibility is not just a legal designation. Under the Employee Retirement Income Security Act of 1974, as amended, the fiduciary duty is the highest standard of care recognized under the law.
Fiduciaries must ensure that every decision regarding a benefit plan is made with…
Whistleblower Claims CVS PBM Overbilled Medicare Part D By As Much As $330M
By Anne Hall
Whistleblower Sarah Benke recently testified in a False Claims Act bench trial that Caremark, which is a pharmacy benefits manager (PBM) for Aetna Life Insurance Co., overbilled Medicare Part D for sponsored prescription drugs. She estimated that the CVS-owned PBM caused $240 to $330 million in damages by billing Medicare for reimbursement amounts that were higher than it paid pharmacies…
Episode 2: From Navy SEAL to Nonprofit GC: A Mission-Driven Legal Journey
By Anne Hall
Listen to the Podcast Episode on
Episode Summary:
In this episode of In-House Counsel and HR Perspectives, host David Hall welcomes Tim Phillips, Chief Legal Officer at Habitat for Humanity International and General Counsel for the Navy SEALS Foundation. With a background that spans Naval Special Warfare, big law, and executive legal leadership at major nonprofits like the American…
Hospitals Increasingly Filing Antitrust Suits Against Blue Cross and Blue Shield Carriers
By Anne Hall
Large hospitals and health systems have filed a spate of antitrust suits against various Blue Cross and Blue Shield (BCBS) carriers, including Elevance Health and Health Care Service Corp. These plaintiffs in the recent lawsuits are those health system giants that opted out of the $2.8 billion antitrust settlement that BCBS agreed to last fall. They had until March 29,…
HHS Issues Memo Rescinding 2022 Guidance on Gender Affirming Care
By Anne Hall
The U.S. Department of Health & Human Services (HHS) has issued a memorandum rescinding its 2022 guidance entitled “Rescission of ‘HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy’.” The rescission cites Section 5(b) of Executive Order 14187, “Protecting Children from Chemical and Surgical Mutilation,” as justification. The rescission of the 2022 HHS guidance is effective…
Federal 340B Drug Pricing Program Failing Patients, Increasing Drug Costs
By Anne Hall
The American Benefits Council has released a new white paper calling for reforms to the federal 340B drug pricing program. According to the paper, the 340B program is failing to meet the needs of the patients that it was designed to help. At the same time, the program is driving up healthcare expenses for employer-sponsored health plans by $5.2 billion…
DOL’s New Retirement Security Rule Remains on Hold as Agency Pauses Appeals
By Anne Hall
The U.S. Department of Labor (DOL) has filed a motion with the U.S. Court of Appeals for the Fifth Circuit to pause its appeals of two federal court cases challenging its new Retirement Security Rule. This move follows two July 2024 federal court orders staying the implementation of the rule, which was supposed to go into effect in September 2024.…
Liability for Employers Handling Discrimination Complaints Without DEI
By Anne Hall
More and more companies are explicitly moving away from diversity, equity, and inclusion (DEI) policies in the wake of the White House’s January executive order addressing the issue. In the aftermath of this exodus, employers now must grapple with how to handle discrimination complaints. Abandoning DEI policies also results in rejecting in-house dispute resolution processes for discrimination complaints.
Dismantling of…