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Health Care Policy and Legislation

News
Trump Administration to Test AI-Powered Prior Authorization in Medicare
09/25/2025
Grace Taylor, MS, MA
The Trump administration is set to launch a decade-long Medicare pilot that uses artificial intelligence (AI)-driven prior authorization to curb costs, sparking bipartisan concern over access to care and patient safety.
The Trump administration is set to launch a decade-long Medicare pilot that uses artificial intelligence (AI)-driven prior authorization to curb costs, sparking bipartisan concern over access to care and patient safety.
The Trump administration is set...
09/25/2025
First Report Managed Care
News
No Surprises Act Cuts Patient Out-of-Pocket Costs but Leaves Premiums Unchanged
09/16/2025
Lisa Kuhns, PhD, MD
The No Surprises Act (NSA) has succeeded in lowering out-of-pocket spending for privately insured adults in states that previously lacked protections from surprise medical bills, though it has not significantly reduced premiums or overall...
The No Surprises Act (NSA) has succeeded in lowering out-of-pocket spending for privately insured adults in states that previously lacked protections from surprise medical bills, though it has not significantly reduced premiums or overall...
The No Surprises Act (NSA) has...
09/16/2025
First Report Managed Care
News
DOJ and HHS Form Working Group to Intensify Health Care Fraud Enforcement
07/02/2025
Juliet Gallagher
The US Department of Health and Human Services (HHS) and the US Department of Justice (DOJ) announced the formation of the DOJ-HHS False Claims Act (FCA) Working Group, a joint initiative designed to strengthen enforcement efforts against...
The US Department of Health and Human Services (HHS) and the US Department of Justice (DOJ) announced the formation of the DOJ-HHS False Claims Act (FCA) Working Group, a joint initiative designed to strengthen enforcement efforts against...
The US Department of Health and...
07/02/2025
First Report Managed Care
Shackleton
Conference Coverage
The Advocacy Frontier: Navigating PBM Reform, Step Therapy, and More
06/25/2025
Explore how state policies on copay accumulators, PBMs, and step therapy are shaping the future of infusion care—and what you can do about it.
Explore how state policies on copay accumulators, PBMs, and step therapy are shaping the future of infusion care—and what you can do about it.
Explore how state policies on...
06/25/2025
First Report Managed Care
Conference Coverage
Aligning Stakeholders in Oncology’s Evolving Drug Distribution Landscape
05/28/2025
Kirollos S. Hanna, PharmD, BCPS, BCOP, FACC
A guest expert from Asembia 2025 explores how reimagining limited drug distribution models in oncology can eliminate care fragmentation, enhance patient outcomes, and foster stronger collaboration among providers, pharmacies, payers, and...
A guest expert from Asembia 2025 explores how reimagining limited drug distribution models in oncology can eliminate care fragmentation, enhance patient outcomes, and foster stronger collaboration among providers, pharmacies, payers, and...
A guest expert from Asembia 2025...
05/28/2025
First Report Managed Care
Conference Coverage
Navigating MFP Implementation: Stakeholders Weigh IRA Challenges at Asembia 2025
05/22/2025
Juliet Gallagher
At Asembia 2025, industry experts from Cencora gathered to dissect the pressing challenges and evolving implementation framework of the Inflation Reduction Act’s (IRA) Maximum Fair Price (MFP) provision.
At Asembia 2025, industry experts from Cencora gathered to dissect the pressing challenges and evolving implementation framework of the Inflation Reduction Act’s (IRA) Maximum Fair Price (MFP) provision.
At Asembia 2025, industry...
05/22/2025
First Report Managed Care
Conference Coverage
What Payers and Manufacturers Need to Know About IRA Implementation
04/29/2025
Juliet Gallagher
In a packed session at Asembia 2025, Brian Corvino, lead partner at Deloitte Consulting, and Blasine Penkowski, former chief strategic customer officer at Johnson & Johnson, walked attendees through key lessons from early implementation of...
In a packed session at Asembia 2025, Brian Corvino, lead partner at Deloitte Consulting, and Blasine Penkowski, former chief strategic customer officer at Johnson & Johnson, walked attendees through key lessons from early implementation of...
In a packed session at Asembia...
04/29/2025
First Report Managed Care
Conference Coverage
The New Reality for Payers in a Shifting Health Care Environment
04/28/2025
Juliet Gallagher
At Asembia 2025, Luke Greenwalt, vice president at IQVIA, presented a sweeping overview of the evolving health care and pharmaceutical landscape, highlighting critical trends for payers as the industry enters a period of accelerated change.
At Asembia 2025, Luke Greenwalt, vice president at IQVIA, presented a sweeping overview of the evolving health care and pharmaceutical landscape, highlighting critical trends for payers as the industry enters a period of accelerated change.
At Asembia 2025, Luke Greenwalt,...
04/28/2025
First Report Managed Care
Regulatory Insights
Making Sense of the Federal Budget Process for Managed Care
02/27/2025
Adam Colborn, JD
The Inflation Reduction Act (IRA) of 2022 was passed as a reconciliation bill. This year, we may have two or more overlapping budget bills. They’re likely to contain some of the most significant legislation of 2025. But how are they...
The Inflation Reduction Act (IRA) of 2022 was passed as a reconciliation bill. This year, we may have two or more overlapping budget bills. They’re likely to contain some of the most significant legislation of 2025. But how are they...
The Inflation Reduction Act...
02/27/2025
First Report Managed Care
Cover Story
What’s Next for Health Care Policy in the US?
11/25/2024
Adam Colborn, JD
With new faces and shifting power dynamics in Washington, concerns about health care policy in 2025 are rising, including potential reform of PBMs, the 340B program, and the IRA, as well as the push for expanded access to innovative therapies...
With new faces and shifting power dynamics in Washington, concerns about health care policy in 2025 are rising, including potential reform of PBMs, the 340B program, and the IRA, as well as the push for expanded access to innovative therapies...
With new faces and shifting...
11/25/2024
First Report Managed Care

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