These 3 Things Will Be in the PBM Legislation | PBMI 2024
Patrick Cooney, president of The Federal Group, says elimination of spread pricing is one of the three key elements of the PBM legislation that he believes is likely to pass during the lame-duck session of Congress after the Nov. 5 election.
Patrick Cooney rates the chances of Congress passing PBM legislation during the lame-duck session after the Nov.5 election day as high.
Cooney, the president of The Federal Group, a Washington, D.C., lobbying firm also has some projections about what the legislation will include.
First, elimination of spread pricing in Medicare. Some of the industry's critics want that provision to go further and include people with employer-based insurance. Second, a requirement that rebates get passed through to plan sponsors Industry critics want that provision to be comprehensive and include group purchasing organizations. Third, what Cooney described as "pretty robust reporting requirements."
"Transparency is sort of the name of the game in DC this year," he said. Cooney. PBMs are not alone in the trend, he added. "The focus is definitely on hospitals [and] definitely on insurers."
Cooney is a paid consultant to the Pharmacy Benefit Management Institute. He spoke Wednesday at the 2024 PBMI Annual National Conference in Orlando, Florida. This video interviewed was conducted the day afterward.
In this episode of the "Meet the Board" podcast series, Briana Contreras, Managed Healthcare Executive editor, speaks with Ateev Mehrotra, a member of the MHE editorial advisory board and a professor of healthcare policy and medicine at Harvard Medical School. Mehtrotra is also a hospitalist at the Beth Israel Deaconess Medical Center in Boston. In the discussion, Contreras gets to know Mehrotra more on a personal level and picks his brain on some of his research interests including telehealth, alternative payment models and price transparency.
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Group Purchasing Organizations of 'Big 3' PBMs Cloud Transparency, Says Critic | PBMI 2024
September 6th 2024Greg Baker, CEO of AffirmedRx, did not hold back in criticizing CVS Caremark, Optum Rx and Express Scripts and their group purchasing organizations today at the PBMI Annual National Conference.
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