The M3P Solution is Making Waves!

November 13, 2025

EGWP Medicare

On Jan. 1, 2025, Express Scripts successfully launched the M3P solution to nearly all Medicare Health Plan clients – plus the entire EGWP line of business. By the end of Q4, an impressive 76,744 members had opted in. We’re proud to lead the industry in repayment rates, with 96% of members paying their billed amounts – thanks to our seamless online enrollment and proactive customer service encouraging AutoPay. Nearly 44% of participants are enrolled in AutoPay, making payments effortless. And members are loving it!

In a recent survey:

  • 69% were promoters of the program
  • 67% said it absolutely helped them afford their medication
  • Most learned about M3P through their Health Plan or Express Scripts and found both the election process and AutoPay enrollment easy.

The M3P solution isn’t just a program – it’s a game-changer for affordability and convenience.

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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