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

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

EGWP marketplace medicaid Medicare

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

legislation

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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June 10, 2026

marketplace medicaid

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