The Biden administration is proposing a 2.8% decrease to physician payments in its newly released pay proposal for physicians, drawing near-immediate protest from the industry. Unveiled Wednesday afternoon, the calendar year 2025 Medicare Physician Fee Schedule proposed rule outlines new policies focused on primary care, preserved telehealth flexibilities and a strengthened Medicare Shared Savings Program ...

The Inflation Reduction Act calls for prescription drug prices for seniors on Medicare to be lowered and out-of-pocket expenses capped at $2,000 per year starting in 2025, the White House said. The act also capped the price of insulin, which helps regulate diabetes, at $35 a month for Medicare users.

The Federal Trade Commission released a critical report detailing how pharmacy benefit managers—like CVS Health’s Caremark, Cigna’s Express Scripts and UnitedHealth’s Group OptumRx, which manage 80% of American prescriptions—could be driving up the costs of some medications and favoring their own pharmacies at the expense of independent drug stores.

The Federal Trade Commission staff is having trouble getting information from the big pharmacy benefit managers, but it believes that the big PBMs may have too "outsized influence" over the U.S. pharmaceutical system and may be steering prescription revenue to their own pharmacies.

The Wall Street Journal has added to the pressure on Medicare Advantage plan issuers by publishing its own analysis of how the issuers score their enrollees' health.

The Federal Trade Commission is preparing a lawsuit against the three largest drug intermediaries over their use of rebates for insulin and other drugs, according to a person familiar with the probe. The agency has been investigating whether the rebate practices of insulin manufacturers and three pharmacy benefit managers — units of CVS Health Corp., ...