Minnesota’s Governor Signs Omnibus Bills to End the Legislative Session

July 9, 2025

EGWP marketplace medicaid Medicare

While the state was grieving the assassination of Speaker Emeritus Melissa Hortman (D) and her husband as well as the attempted murder of state Sen. John Hoffman (D) and his wife, Gov. Tim Walz (D) unceremoniously signed the Health and Human Services Omnibus bill into law.

The bill includes a “single PBM model” provision to contract with a single PBM for Medicaid and MinnesotaCare by Jan. 1, 2027. The bill also includes a 60-day notice requirement by the insurer or PBM before modifying a formulary during the plan year and repeals the authority to seek federal approval of a public option.

In another signed bill, HF 4, funds are appropriated for a reinsurance program for two years by assessing health plans.

legislation

Virginia and Hawaii Introduce PDAB Legislation

The Virginia Senate introduced a bill to establish a Prescription Drug Affordability Board (PDAB) to review drugs with a wholesale acquisition cost (WAC) of $60,000 or more per year or a WAC increase of $3,000 or more in any 12-month period. For drugs deemed to cause an affordability challenge, the legislation authorizes the PDAB to […]
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February 12, 2026

EGWP marketplace medicaid Medicare

Solutions

AHIP Shares Update on Plan Progress to Simplify Prior Authorization

AHIP shared progress on the voluntary, multi-year commitments made by AHIP, BCBSA, and leading health plans (including Cigna Healthcare) to streamline and simplify prior authorization. Health plans serving nearly 270 million Americans are participating in this initiative. The 2026 commitments took effect on Jan. 1 and include: reducing the scope of claims subject to prior […]
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February 12, 2026

EGWP marketplace medicaid Medicare

legislation

DOL Issues Proposed Rule on Improving Transparency into PBM Fees

Pursuant to President Trump’s Executive Order “Lowering Drug Prices by Once Again Putting Americans First,” the Department of Labor’s (DOL’s) Employee Benefits Security Administration (EBSA) issued a proposed rule that would require providers of PBM services and affiliated entities of brokerage and consulting services to disclose direct and indirect compensation to their self-funded ERISA fiduciary […]
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February 12, 2026

EGWP marketplace medicaid Medicare

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