"[T]he provisions of [Executive Order 14273] appear intended to drive down the prices that the federal government pays for drugs and reduce out-of-pocket costs for patients, with many provisions designed to do both.... [P]rivate payors are also targeted through efforts to increase transparency in their compensation models."  MORE >>

"The 89-page complaint details the decline of independent pharmacies in Michigan and across the United States and alleges that ESI and Prime's arrangement ... harmed Michigan residents by decreasing healthcare access, increasing healthcare costs and decreasing the number of small businesses in Michigan. This is the latest in a series of lawsuits alleging collusion by the nation's major PBMs and continues a nationwide trend of increased scrutiny of PBM conduct." [Michigan v. Express Scripts, Inc., No. 25-11215 (E.D. Mich. complaint filed Apr. 28, 2025)]  MORE >>

"In June, [CMS] will name the participating states for the agency's new Cell and Gene Therapy (CGT) Access Model.... Insurers, however, are wary broadly of the financial costs associated with cell and gene therapies ... Nearly three-fourths (73%) of respondents said they view the affordability of cell and gene therapies as a moderate or major challenge in the next two to three years. For health plans, that figure rises to 87%."  MORE >>

"[1] Demonstrating benefits ROI ... [2] Managing rising healthcare costs ... [3] Meeting the demand for personalization ... [4] Integrating new technologies ... [5] Overcoming the communication challenge."  MORE >>

"[R]educing out-of-network prices would also lower negotiated prices, but potentially at the cost of narrower hospital networks. Aggressive regulation could induce substantial hospital exit, but only under the restrictive assumption that negotiators cannot anticipate the exits."  MORE >>

"Employers can work with third-party vendors that provide a platform for locating licensed child-care providers with real-time availability. Employees can identify child-care providers that meet their unique needs.... [S]tipends or reimbursements can be paid from the employer to the child-care provider or the employee. Another option is employer contributions to employees' dependent care flexible spending accounts or dependent care assistance program (DCAP)."  MORE >>

"The May 1, 2025 announcement represents a shift in labor policy with significant implications for gig economy businesses and workers. While businesses celebrate the return to a more flexible labor market, and labor advocates warn that this change will leave many gig workers without crucial protections ... until DOL takes further action, the Biden Rule remains in effect for purposes of private litigation."  MORE >>

"The Supreme Court's recent decision in Cunningham v. Cornell University set the bar for pleading standards against ERISA-governed plans laughably low.... [M]any more claims against ERISA-covered plans will get into formal discovery, which means that minutes of fiduciary committee meetings -- whether retirement or welfare plan -- will be scrutinized. It's time to stop treating minutes as a mere formality. Here are three recommendations." [Cunningham v. Cornell Univ., No. 23-1007 (S.Ct. Apr. 17, 2025)]  MORE >>