Democratic Senators Demand Information on Telehealth Provider Affiliations with Eli Lilly and Pfizer

April 9, 2025

EGWP marketplace medicaid Medicare

Four Democratic senators sent a letter to five telehealth companies that have held contracts with Pfizer and Eli Lilly, inquiring about their financial relationships and possible influence on prescriptions for medications. The letter was signed by the ranking member of the Senate Judiciary Committee and member of Senate Democratic leadership, Sen. Dick Durbin (D-IL), and the ranking member of the Senate Health, Education, Labor and Pensions (HELP) Committee, Sen. Bernie Sanders (I-VT), as well as Sens. Peter Welch (D-VT) and Elizabeth Warren (D-MA).

The letter accuses these arrangements of sending direct-to-consumer advertisements that steer patients toward particular medications and create the potential for inappropriate prescribing that can increase health care spending. The letters were addressed to the CEOs of 9amHealth, Thirty Madison (Cove), Form Health, Populus Health Technologies, and UpScriptHealth, and demand answers to questions by April 15.

legislation

CMS Releases Final 2026 MA Policy and Technical Rule; Declines to Finalize Coverage of GLP-1s

On April 4, the Centers for Medicare & Medicaid Services (CMS) finalized the 2026 MA Policy and Technical Changes rule. Of note, CMS is not finalizing certain provisions from the proposed rule, most importantly the proposal requiring coverage of anti-obesity medications (AOMs) in both Medicare and Medicaid. CMS said that it may address these proposals […]
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April 9, 2025

EGWP marketplace medicaid Medicare

legislation

Budget Reconciliation Process Continues with Senate Consideration of Revised House Resolution

On April 5, the Senate voted 51-48 to pass a modified version of the House-passed budget resolution with reduced deficit reduction targets for Senate committees as compared to the House. Specific to health care, the revised Senate resolution instructs the Senate Finance Committee (SFC), which has jurisdiction over Medicaid, to propose changes that will increase […]
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April 9, 2025

medicaid

legislation

2026 Final Rate Announcement for MA and Final Part D Program Instructions

On April 7, CMS released the Calendar Year (CY) 2026 MA and Part D Final Rate Announcement and the Final CY 2026 Medicare Part D Program Instructions. The Administration strongly defended its focus on fraud, waste, and abuse, while protecting beneficiaries. The final rate notice increases average payments to MA plans by 5.06% up from […]
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April 9, 2025

EGWP medicaid Medicare

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