New York Announces Platform to File PBM Complaints Easier

April 9, 2025

EGWP marketplace medicaid Medicare

Gov. Kathy Hochul (D) recently announced the development of Department of Financial Services (DFS) Connect, a digital platform for New Yorkers to file complaints about drug price spikes. “Local small pharmacies” will also be able to use DFS Connect to seek assistance in resolving claims against PBMs.

The new platform replaces an outdated system and has the goal of giving New Yorkers a voice in keeping drugs affordable, improving oversight, and ensuring better services. According to DFS, since January 2022, they have received more than 300 complaints about PBMs and have recovered a total of more than $1.3 million for pharmacies and consumers.

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June 19, 2026

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Bicameral Patients before Monopolies Act reintroduced

On May 13, bipartisan lawmakers in the House and Senate reintroduced the Patients Before Monopolies (PBM) Act (S.4509/H.R.8779), legislation that would prohibit common ownership of PBMs, insurers, and pharmacies. Sponsored by Sens. Warren (D-MA) and Josh Hawley (R-MO) alongside Reps. Diana Harshbarger (R-TN) and Jake Auchincloss (D-MA), the bill would require impacted organizations to divest […]
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June 10, 2026

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legislation

CMS announces ePA acceleration initiative, democrats seek to repeal WISeR Model

The Centers for Medicare & Medicaid Services (CMS) is advancing its electronic prior authorization (ePA) efforts through a newly established Electronic Prior Authorization Acceleration initiative to address key challenges and drive solutions ahead of 2027 requirements. To date, 29 health care organizations – including health systems, electronic health record developers, physician practices, networks, and digital health […]
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June 10, 2026

EGWP marketplace medicaid Medicare

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Tri-Departments release fertility excepted benefits proposed rule

On May 10, the Departments of Labor, HHS, and Treasury (the Departments) issued a proposed rule that would create a new category of limited excepted benefits to allow employers to offer stand-alone fertility benefits to their employees, similar to dental, vision, and other supplemental coverage. Benefits would be limited to fertility-related items and services for […]
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Massachusetts issues final prior authorization rule

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June 10, 2026

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HHS publishes 2027 Notice of Benefit and Payment Parameters final rule

On May 15, HHS published the 2027 Notice of Benefit and Payment Parameters (NBPP) final rule. The final policies advance the Trump Administration’s goals to reduce improper enrollments, increase program integrity, increase consumer choice, and expand state flexibility. HHS decided not to finalize two significant proposals for 2027, including the Essential Community Provider threshold decrease […]
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