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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.

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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UnitedHealthcare To Slash Prior Authorization Use For Many Rural Providers

UnitedHealthcare said it’s going to eliminate most requirements for prior authorization for medical care for about 1,500 rural hospitals and their affiliated health care providers by this fall. The change will affect all of the small, isolated rural hospitals classified as “critical access hospitals.” In January, the United States had 1,381 critical access hospitals, according ...

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Brokers Get Paid More to Enroll Seniors in Medicare Advantage. Is That a Problem?

The system of paying Medicare agents and brokers more money if they enroll someone in a Medicare Advantage plan rather than traditional Medicare with a supplement plan needs to be changed, according to several members of the Medicare Payment Advisory Commission (MedPAC). “The broker compensation piece really frustrates me,” MedPAC member Stacie Dusetzina, PhD, of ...

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Former Deputy Surgeon General Erica Schwartz, M.D., Nominated As CDC Director

President Donald Trump announced Thursday Erica Schwartz, M.D., as his nominee to fill the long-vacant role of director of the Centers for Disease Control and Prevention. Schwartz, who also has a law degree and a master’s of public health, previously served as deputy surgeon general during the president’s first term. She is a Navy officer ...

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HHS Brings On An Affordability Czar

The Trump administration is bringing on a new official to focus on health care affordability, the Department of Health and Human Services tells Axios. Why it matters: The personnel move suggests the administration is attempting to respond to voters’ concerns about health care costs ahead of the midterm elections. Driving the news: HHS has appointed Casey Mulligan as ...

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Rising ACA Costs Leave Many Unable To Pay for Coverage

Higher health insurance costs are forcing some people to walk away from coverage even after signing up. About 14% of people who enrolled in Affordable Care Act (ACA) plans for 2026 did not pay their first monthly premium, according to a new analysis from Wakely Consulting Group, an actuarial firm. That’s much higher than the ...

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