PHARMACEUTICALS
Litigation and Enforcement Highlights – January 2021
Amy Y. Gu, Managing Editor January 14, 2021
We kick off the new year with a handful of new developments in healthcare litigation and enforcement that transpired at the end of 2020. In price transparency, a pair of legal challenges intended to block transparency efforts in drug pricing and hospital pricing, respectively, were denied by the circuit courts. On the antitrust front, the Federal Trade Commission saw both victory and defeat in its challenges of proposed mergers that would lessen competition in the healthcare markets. Judges Refuses to Block California’s Drug Pricing Transparency Law SB 17 On …
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A Decision in Rutledge: The Supreme Court Upholds States’ Rights to Regulate Health Care Costs
Katie Gudiksen, Senior Health Policy Researcher December 11, 2020
On December 10, 2020, the Supreme Court overturned a decision by the Eighth Circuit and upheld an Arkansas Law to regulate pharmacy benefit managers (PBMs). In a unanimous decision (8-0, Justice Barrett did not participate in the case), the court reaffirmed that state regulation of prices is not preempted by the Employee Retirement Income Security Act of 1974 (ERISA). The ruling in this case found that Arkansas’ law was a price regulation. In effect, the law required PBMs to reimburse pharmacies at a rate above the price the pharmacy paid …
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The Source Roundup: December 2020 Edition
Amy Y. Gu, Managing Editor December 1, 2020
In the final monthly roundup of this tumultuous year, we highlight articles and reports that examine 1) rising and varying healthcare costs and their pronounced impact on Americans during the pandemic; 2) antitrust enforcement challenges of private equity partial ownership and joint ventures; 3) continued success of the Affordable Care Act in both marketplace participation and coverage protections for Americans amidst the pandemic; and 4) value-based pricing for COVID-19 treatment and vaccines. Rising and Varying Healthcare Costs Increase Burden to Americans In the Kaiser Family Foundation report How costly …
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Pharmacy Benefit Managers Under Legal Scrutiny – U.S. Supreme Court to Decide if States Can Regulate PBM Reimbursement to Pharmacies
Katie Gudiksen, Senior Health Policy Researcher and Sammy Chang October 5, 2020
On October 6, the Supreme Court will hear oral arguments in the case Rutledge v. Pharmaceutical Care Management Association (PCMA). A decision in this case will resolve whether an Arkansas law to regulate pharmacy benefit managers (PBMs), Act 900, is preempted by federal law and may affect the enforceability of similar laws passed by at least thirty-five other states.[1] Arkansas passed Act 900 to protect pharmacies from dispensing drugs at a loss. Specifically, the law requires PBMs, when challenged by a pharmacy, to raise the reimbursement rate for a drug …
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The Source Roundup: September 2020 Edition
Kendall Kohlmeyer, Student Fellow September 1, 2020
This month in health policy research, surprise billing and changes in market structures fuel concerns about competition and consumer choice. In addition, some studies on pharmaceutical costs produced hopeful reports. Healthcare Market Competition and Consolidation Consolidation Trends In a Health Affairs study, Consolidation of Providers into Health Systems Increased Substantially, 2016-18, Michael Furukawa et al. analyzed provider consolidation trends. The rate of physician affiliation with a health system increased by 11 to 51 percent in 2018. Based on the 556 health systems the authors identified, the median number of …
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The Source Roundup: July 2020 Edition
Kendall Kohlmeyer, Student Fellow July 1, 2020
The Source continues to extend wishes of safety and good health to you and your loved ones. As the pandemic causes the healthcare industry financial tragedy, health law experts share important considerations for policymakers, providers, and payers. Many authors hope the pandemic will effect much-needed lasting improvements in the efficiency and efficacy of health care in the U.S. Antitrust Experts Recommend More Rigorous Regulation of Healthcare Consolidation In Preventing Anticompetitive Healthcare Consolidation: Lessons from Five States, published by the Source on Healthcare Price & Competition, authors Jaime King, et …
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The Source Roundup: May 2020 Edition
Source Fellow May 1, 2020
By: Swaja Khanna, Student Fellow With the coronavirus pandemic causing shelter-in-place restrictions around the world, we here at The Source hope you are staying safe and healthy as we catch you up on some of the articles and reports in health policy this month. In this edition of the Source Roundup, we cover articles and reports that discuss: (1) the cost of hospital care for COVID-19 for the uninsured, (2) how health costs may change in the pandemic, (3) surprise out-of-network billing from ambulance transportation, (4) in-network ASC episodes that …
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[In the Press] The Source Quoted in Pharmacy Today Regarding Supreme Court Case Rutledge v PCMA
Amy Y. Gu, Managing Editor April 1, 2020
Senior Health Policy Researcher Katie Gudiksen was quoted in the 4/1/2020 Pharmacy Today article The skinny on the PBM case before the U.S. Supreme Court: “Many people incorrectly equate the term ‘ERISA plan’ with ‘self-funded plans,’” said Katherine L. Gudiksen, PhD, MS, who is senior health policy researcher for The Source on Healthcare Price and Competition, a program associated with the University of California Hastings College of the Law. “Congress saved any state insurance law from ERISA preemption, so states [are able to] continue to regulate insurance—including health insurance—in the state,” …
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The Source Roundup: April 2020 Edition
Ada Shao, Student Fellow April 1, 2020
We hope that you and loved ones are staying well as we together persevere through the unprecedented circumstances brought on by the COVID-19 pandemic. The current situation has brought to the forefront a number of issues our healthcare system currently faces, including the potential costs associated with treating those affected by COVID-19. In this month’s Source Roundup, we begin by looking at the expected treatment costs for patients affected by COVID-19 and examine how price capping may be a means to reduce healthcare costs. We also highlight articles that discuss …
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Litigation and Enforcement Highlights – February 2020
Amy Y. Gu, Managing Editor February 18, 2020
The Source has been closely following legal challenges to state legislation that seek to promote competition and contain costs in healthcare services. In this month’s Litigation and Enforcement Highlights, we roundup the latest developments in some of the pending cases as well as new lawsuits that have been filed to derail state efforts to address rising prescription drug costs. Arkansas: Supreme Court Grants Review of PBM Law In November 2019, the Source Blog covered the long litigious history of lawsuits filed against various pharmacy benefit manager (PBM) laws from …
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