Regulated Markets

Stay informed on the latest news and updates.

The world of Regulated Markets is constantly changing. You need a dependable information source that changes along with it.

Visit our site often to stay up to date on recent federal and state legislation, breaking news, current initiatives, thought leadership and upcoming events related to Medicare, Medicaid, Marketplace plans and EGWP.

legislation

House Judiciary Subcommittee Holds Hearing on the Role of PBMs

On Sept. 11, the House Judiciary Subcommittee on the Administrative State, Regulatory Reform, and Antitrust held a hearing titled, “The Role of Pharmacy Benefit Managers,” featuring academic witnesses. The hearing focused on transparency, affordability, and access, as well as the relationship between PBMs and independent pharmacies. Witnesses highlighted the critical role of PBMs in the […]
read more >

Oct 8, 2024

EGWP marketplace medicaid Medicare

Initiatives

House Education and the Workforce Committee Holds Hearing in Honor of ERISA 50th Anniversary

On Sept. 10, the House Education and Workforce Subcommittee on Health, Employment, Labor, and Pensions held a hearing titled, “ERISA’s 50th Anniversary: The Value of Employer-Sponsored Health Benefits.” Policy experts and advocates representing large employers, small business owners, and consumers discussed potential ways to strengthen the Employee Retirement Income Security Act (ERISA) and employer-sponsored coverage. […]
read more >

EGWP Medicare

legislation

Alaska Governor Approves PBM Regulation

After delaying a decision for several months, Alaska Gov. Mike Dunleavy (R) signed HB 226, an anti-PBM bill that passed by the legislature earlier this year. The bill contains problematic language that could ultimately raise costs and reduce choice for employers and consumers. Those provisions include restrictions on the use of white bagging and home […]
read more >

EGWP marketplace medicaid Medicare

legislation

Texas Pharmaceutical Initiative Board Approves Business Plan

Recently, the Texas Pharmaceutical Initiative (TPI) Board unanimously approved the TPI Business Plan for improving PBM services, finding administrative savings, and lowering drug costs. The TPI Board adopted the Plan after several changes that were finalized during the meeting. In the area of Medicaid services, Board Chairman Mike McKinney, MD, acknowledged that other states achieved […]
read more >

EGWP marketplace medicaid Medicare

legislation

California Governor Acts on Artificial Intelligence (AI) Legislation

Last month, Gov. Gavin Newsom (D) announced that he was signing a series of bills to protect residents from fast-moving AI technology, while vetoing legislation that falls short of providing needed flexibility to companies that are creating and using Generative AI systems.  Overall, the governor signed 17 bills during the year covering the development, use, […]
read more >

EGWP marketplace medicaid Medicare

Guidance

California PBM Legislation Vetoed by Governor

Governor Gavin Newsom (D) vetoed SB 966, an omnibus PBM regulation bill pushed by PhRMA. With his veto, the governor recognized the real intent of the bill, but more importantly, that SB 966 failed to achieve lower costs or improve efficiency of health care services for our clients and customers.  Cigna initiated client activation campaigns in […]
read more >

EGWP marketplace medicaid Medicare


Recent happenings in the regulated markets space, including updated regulatory guidance and policy changes.

legislation

House Judiciary Subcommittee Holds Hearing on the Role of PBMs

On Sept. 11, the House Judiciary Subcommittee on the Administrative State, Regulatory Reform, and Antitrust held a hearing titled, “The Role of Pharmacy Benefit Managers,” featuring academic witnesses. The hearing focused on transparency, affordability, and access, as well as the relationship between PBMs and independent pharmacies. Witnesses highlighted the critical role of PBMs in the […]
read more >

October 8, 2024

EGWP marketplace medicaid Medicare

Initiatives

House Education and the Workforce Committee Holds Hearing in Honor of ERISA 50th Anniversary

On Sept. 10, the House Education and Workforce Subcommittee on Health, Employment, Labor, and Pensions held a hearing titled, “ERISA’s 50th Anniversary: The Value of Employer-Sponsored Health Benefits.” Policy experts and advocates representing large employers, small business owners, and consumers discussed potential ways to strengthen the Employee Retirement Income Security Act (ERISA) and employer-sponsored coverage. […]
read more >

October 8, 2024

EGWP Medicare

legislation

Alaska Governor Approves PBM Regulation

After delaying a decision for several months, Alaska Gov. Mike Dunleavy (R) signed HB 226, an anti-PBM bill that passed by the legislature earlier this year. The bill contains problematic language that could ultimately raise costs and reduce choice for employers and consumers. Those provisions include restrictions on the use of white bagging and home […]
read more >

October 8, 2024

EGWP marketplace medicaid Medicare

legislation

Texas Pharmaceutical Initiative Board Approves Business Plan

Recently, the Texas Pharmaceutical Initiative (TPI) Board unanimously approved the TPI Business Plan for improving PBM services, finding administrative savings, and lowering drug costs. The TPI Board adopted the Plan after several changes that were finalized during the meeting. In the area of Medicaid services, Board Chairman Mike McKinney, MD, acknowledged that other states achieved […]
read more >

October 8, 2024

EGWP marketplace medicaid Medicare

legislation

California Governor Acts on Artificial Intelligence (AI) Legislation

Last month, Gov. Gavin Newsom (D) announced that he was signing a series of bills to protect residents from fast-moving AI technology, while vetoing legislation that falls short of providing needed flexibility to companies that are creating and using Generative AI systems.  Overall, the governor signed 17 bills during the year covering the development, use, […]
read more >

October 8, 2024

EGWP marketplace medicaid Medicare

Guidance

California PBM Legislation Vetoed by Governor

Governor Gavin Newsom (D) vetoed SB 966, an omnibus PBM regulation bill pushed by PhRMA. With his veto, the governor recognized the real intent of the bill, but more importantly, that SB 966 failed to achieve lower costs or improve efficiency of health care services for our clients and customers.  Cigna initiated client activation campaigns in […]
read more >

October 8, 2024

EGWP marketplace medicaid Medicare

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Original research, studies and thought leadership pieces relevant to the regulated markets business.

Solutions

AFHC Sends Letter to Congress in Support of HDHP Reforms

The Alliance to Fight for Health Care (AFHC), of which The Cigna Group is a founding member, sent a letter to House Leadership on Sept. 17 to urge passage of legislation to provide flexibility to provide chronic disease preventive care pre-deductible. AFHC highlighted H.R. 3800, the Chronic Disease Flexible Coverage Act, bipartisan legislation that would […]
read more >

EGWP marketplace medicaid Medicare

Solutions

Medicare Prescription Payment Plan (M3P) Educational Overview

With Open Enrollment right around the corner, Medicare eligible members can begin opting in to the Medicare Prescription Payment Plan (M3P). Discover more about the M3P program and how Express Scripts by Evernorth supports clients with a solution. Watch now: https://bit.ly/47yF5vf
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Medicare

Solutions

Learn how Express Scripts by Evernorth can help plans succeed in the complex world of government-regulated health care

The world of Regulated Markets is constantly changing. Express Scripts by Evernorth offers the expanded capabilities you need to succeed in today’s regulated space by turning insightful data into innovative solutions that drive affordability and opportunities for better member outcomes. Watch now: https://bit.ly/3swVK23
read more >

marketplace medicaid Medicare

Guidance

Inflation Reduction Act (IRA) Educational Resources

As a means of providing additional support to our clients, the following videos and companion guides have been created to provide education and awareness to agent/brokers and customer service. This content is designed to be an educational resource for these key stakeholders to highlight recent and upcoming changes to the Medicare Part D program. This […]
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Aug 21, 2024

Medicare

perspectives

What impact will the Inflation Reduction Act have on health plans?

Plan sponsors should be aware of the effects the law will have on Medicare Part D over the coming years.
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Mar 6, 2024

EGWP marketplace medicaid Medicare

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