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Industry Updates

This broad category includes articles concerning health insurance costs, carrier and health plan news, changing benefits technology, and surveys by the Kaiser Family Foundation and others on employee benefits.

Insurers Have Eliminated 11% Of Prior Authorizations Under Reform Pledge

Last summer, the insurance industry broadly agreed to reform a major healthcare pain point: prior authorization. Now, two of the industry’s leading organizations are offering a look at progress toward those goals. AHIP and the Blue Cross Blue Shield Association released a report on Tuesday that found leading health plans reduced prior authorizations for an array of ...

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CMS, FDA Announce New Program To Speed Up Medicare Coverage Of Breakthrough Medical Devices

The Trump administration unveiled a new program to speed up Medicare coverage for breakthrough devices, touting that the new pathway cuts red tape for medical device companies to gain reimbursement. The Centers for Medicare and Medicaid Services (CMS) and the U.S. Food and Drug Administration (FDA) announced on Thursday the Regulatory Alignment for Predictable and ...

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Johnson & Johnson To Launch On TrumpRx With 4 Of Its Prescription Drugs

Drug-making giant Johnson & Johnson will officially start marketing four of its medications on the Trump administration’s TrumpRx website on Friday, CBS News exclusively learned. The pharmaceutical company announced in January that it had entered into a voluntary agreement with the Trump administration to lower costs for Americans by providing Medicaid access to affordable prescriptions ...

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Aetna, Cigna, Elevance And UnitedHealth Back New Prior Authorization Standards Push

Big health insurers said today that they will standardize the process for submitting requests for prior authorizations for coverage for many common procedures by Jan. 1, 2027. Managers of the standards effort will start by applying it to “medical services that are commonly subject to prior authorization, such as orthopedic surgeries and imaging services, including ...

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‘Don’t Be A Wimp,’ Mark Cuban Tells Lawmakers Hesitant To Break Up PBMs

Mark Cuban has a simple message for Congress: “Don’t be a wimp” and break up the healthcare industry’s biggest conglomerates to restore a competitive and efficient market. Speaking Tuesday at Politico’s Health Care Summit, the celebrity entrepreneur and co-founder of Mark Cuban Cost Plus Drugs Company, a direct-purchase marketplace for generic drugs, painted the picture ...

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Specialty Drugs Now Consume Over Half Of Total Drug Spend

Employers and health plans continue to grapple with rising specialty drug costs as utilization growth and an expanding pipeline reshape benefit strategy, according to Pharmaceutical Strategies Group’s 13th annual Specialty Drug Benefits Report, which surveyed benefits leaders across employers, health plans and union-sponsored plans nationwide. Specialty drugs now account for more than half of total ...

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Trump Executive Order Could Nudge Psychedelics Toward Employer Drug Plans

A new executive order could eventually put psychedelic drugs on employer health plans’ prescription drug formularies. President Donald Trump signed an executive order Saturday that calls for “accelerating medical treatments for serious mental illness.” The order does not address matters such as health plan provider networks or health plan coverage for inpatient treatment for mental ...

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‘Hospitals adverse to transparency’—clashing industry groups spar on mulligan 340B rebate pilot

Hospital and pharma groups have sharpened their spears for the rematch on 340B rebates. In comment letters submitted just ahead of a Monday deadline, the stakeholders weighed in on a contentious Trump administration pilot program that would overhaul drug discounts hospitals have received for the past 30 years to subsidize safety-net care. Rather than receive ...

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RFK Jr. Grilled Over Vaccines, MAHA In Back-To-Back Hearings: Key Takeaways

House members got their first opportunity Thursday to grill Health and Human Services Secretary Robert F. Kennedy Jr., as he kicked off a marathon series of seven congressional hearings in seven days with back-to-back hearings in the Ways and Means and Appropriations Committees. In the two appearances, his first before Congress in 2026, Kennedy defended his record in leading the nation’s health agency as Democrats sought to push back ...

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Stakeholders Urge Labor Department To Finalize PBM Transparency Rule

Employers, lawmakers, providers and more said the Department of Labor should quickly finalize disclosure mandates for the controversial drug middlemen.

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