New York Seeks Transparency from PBMs and Drug Manufacturers

February 11, 2025

EGWP marketplace medicaid Medicare

New York Gov. Kathy Hochul (D) recently gave her state of the state address setting forth her priorities for the 2025 legislative session.

With the overarching theme of “affordability,” Gov. Hochul announced that she will introduce “nation-leading legislation requiring greater transparency from PBMs in order to hold PBMs and drug manufacturers accountable for any hidden and unnecessary costs they add to prescription drug prices.”

She also stated that they will explore drug importation and take action to enforce the state’s behavioral health requirements by holding health insurance companies accountable. More details on these initiatives are expected in the governor’s proposed budget, which will be released on Jan. 21.

legislation

CMS Releases the CY2026 Advance Rate Notice and Draft Part D Program Instructions

On Jan. 10, CMS released the Calendar Year (CY) 2026 Medicare Advantage and Part D Advance Notice which includes methodological and payment policy changes for the programs in 2026. The Advance Notice also includes draft program instructions for CY 2026 for the Medicare Part D program under the redesigned Part D benefit as required by […]
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February 11, 2025

EGWP Medicare

legislation

HHS Releases 2026 Notice of Benefit and Payment Parameters Final Rule

On Jan. 13, HHS issued the final Notice of Benefit and Payment Parameters for 2026 (NBPP). HHS states the rule finalizes safeguards to protect consumers from unauthorized changes to their coverage, measures to ensure the integrity of federally run marketplaces, and provisions to make it easier for consumers to understand costs and enroll in coverage. […]
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February 11, 2025

EGWP marketplace medicaid Medicare

legislation

HHS Proposes Changes to HIPAA Security Rule

On Dec. 27, HHS issued a proposed rule to modify the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule to require health plans, health care clearinghouses, most health care providers, and their business associates, to strengthen cybersecurity protections for individuals’ electronic protected health information (ePHI).  The proposals would address: changes in the […]
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February 11, 2025

EGWP marketplace medicaid Medicare

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