Legislation & Regulation

Discover essential legislative and regulatory resources tailored for managed care pharmacy professionals. Stay informed with the latest updates, policies, and advocacy tools to effectively navigate and influence the health care landscape.

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AMCP Regulatory NewsBreaks
Regulatory NewsBREAK

CMS Issues Explanations for the MFPs for the Medicare Drug Price Negotiation Program, Reminders Related to the Medicare Prescription Payment Plan, and Revised Final Guidance for the Manufacturer Discount Program

On December 20, 2024, the Centers for Medicare & Medicaid Services (CMS) issued explanations for the maximum fair prices (MFPs) for the drugs selected for the IRA’s Medicare Drug Price Negotiation Program for the initial price applicability year (IPAY) 2026.
Legislation & Regulation, Payment Systems
The United States Capitol Building
Letters, Statements & Analysis

AMCP Comments on Enhancing Coverage of Preventive Services Under the Affordable Care Act

The Academy of Managed Care Pharmacy (AMCP) thanks the Department of Health and Human Services, the Department of Labor, and the Department of the Treasure (collectively, the Departments) for the opportunity to provide comments in response to the proposed rule titled “Enhancing Coverage of Preventive Services Under the Affordable Care Act [CMS 9887–P]” published in the Federal Register on October 28, 2024.
Legislation & Regulation
AMCP Regulatory NewsBreaks
Regulatory NewsBREAK

CMS Issues Final Rule on Standards for Electronic Pharmacy Transactions and Medicaid Pharmacy Subrogation

On Dec. 12, 2024, the Centers for Medicare and Medicaid Services (CMS) issued a final rule titled, “Modifications of Health Insurance Portability and Accountability Act of 1996 (HIPAA) National Council for Prescription Drug Programs (NCPDP) Retail Pharmacy Standards; and Modification of the Medicaid Pharmacy Subrogation Standard” (Final Rule).
Legislation & Regulation
Managed Care First Report: What’s Next for Health Care Policy in the US?
AMCP In The News Managed Care First Report

What’s Next for Health Care Policy in the US?

Our Associate Vice President of Congressional Affairs Adam Colborn unpacks the key issues the health policy community should be on watch for when preparing for the incoming presidential administration in a recent article for First Report Managed Care.
Legislation & Regulation
NYS Capitol
Letters, Statements & Analysis

State Update: New York Releases Major Market Conduct Regulations for Pharmacy Benefit Managers

On November 21, the New York Department of Financial Services (DFS) announced sweeping market conduct regulations for pharmacy benefit managers (PBMs) serving health plans in the state. The DFS rule implements a landmark 2021 bill, S. 3762/A. 1396, which imposed restrictions on PBM contracts with health plans and pharmacies and established consumer protections. This action follows previous DFS rulemaking that created a broad definition of pharmacy benefit management services, required PBMs operating in the state to obtain a license, and established annual reporting requirements.
Legislation & Regulation
AMCP Regulatory NewsBreaks
Regulatory NewsBREAK

CMS Issues Physician Fee Schedule Final Rule

On November 1, 2024, the Centers for Medicare and Medicaid Services (CMS) issued the Physician Fee Schedule Final Rule (Final Rule), which is scheduled to be published in the Federal Register on December 9, 2024. In addition to finalizing payment rates, the Final Rule includes a variety of provisions that may impact managed care pharmacy.
Legislation & Regulation