Legislation & Regulation

The Academy of Managed Care Pharmacy (AMCP) issued the following statement from AMCP CEO Susan A. Cantrell, MHL, RPh, CAE, regarding President Trump’s new and proposed tariffs on U.S. imports from Canada, Mexico, and China: “Although President Trump’s new and proposed tariffs aim to level the playing field between American industries and our foreign competitors, we are concerned about the unintended, adverse consequences they may have on the cost of medicines in the U.S.

AMCP shared comments with Centers for Medicare & Medicaid Services (CMS) on the proposed 2026 Policy and Technical Changes to the Medicare Advantage (MA) Program. We applaud CMS’ efforts to address obesity and emphasized the importance of managing costs. AMCP urged CMS to issue guidance on managing drugs in this class to effectively treat obesity as a chronic disease. On the Medicare Transaction Facilitator, we advised CMS to avoid adding unnecessary costs and administrative burdens. We support CMS’ focus on increasing access to generics, biosimilars, and other affordable medications. Lastly, we provided insights on proposed changes to Star Ratings, ensuring member perspectives are represented.

On Jan. 20, 2025, newly inaugurated President Trump signed dozens of Executive Orders concerning a number of G.O.P. policy priorities, including but not limited to: immigration and border security, trade and economic policy, the federal workforce, energy and environmental policy, law and order, and social policies. While health care was not a primary focus of these executive actions, President Trump did withdraw the United States from the World Health Organization and revoked several Biden-era actions related to health policy. Executive Orders are directives from the president that manage operations of the federal government, have the effect of law, may be promulgated by government agencies, and may be overturned by judicial review if they lack support by existing law or the Constitution.

Policymakers frequently target pharmacy benefit managers (PBMs) in a well-meaning attempt to contain rising drug prices, but some proposed changes could have the opposite effect for patients. AMCP encourages PBM reform efforts to focus on common-sense requirements for transparency reporting by PBMs. It’s time for a more nuanced discussion about PBM reform—one that lowers the temperature and puts patients first.

Value-based payments (VBP) systems incentivize providers to improve patient outcomes, reduce costs, and improve the overall patient experience, making them a critical tool for promoting high-quality, affordable care. However, defining and measuring the value of a drug can be complex, especially when considering factors like clinical outcomes, patient characteristics, and population health. AMCP supports the Medicaid VBPs for Patients (MVP) Act to modernize the framework for value-based purchasing arrangements in Medicaid, ensuring that the proper channels exist to connect Medicaid patients with the therapies they need.

Signed into law in 2022, the Inflation Reduction Act (IRA) ushered in Medicare prescription drug pricing reforms and imposed caps on out-of-pocket expenses for Part D beneficiaries. While much discussion and analysis has focused on how the IRA will impact Medicare beneficiaries, Part D plans, and government spending, the impact of the legislation will extend to stakeholders across the U.S. health care industry.

Prescription digital therapeutics (PDTs) are software-based therapies shown to benefit those with mental health conditions like depression. However, many PDTs do not currently fit into one of the statutorily defined coverage categories for the Medicare or Medicaid programs, leaving beneficiaries of those programs—which include some of America’s most vulnerable populations—without access to these effective and accessible treatments. AMCP supports the Access to Prescription Digital Therapeutics Act, an important bipartisan bill that would help remedy this disparity by creating a comprehensive benefit category and expanding Medicare coverage to include PDTs.

The Ensuring Community Access to Pharmacist Services (ECAPS) Act of 2025 (H.R. 3164) is an important bipartisan bill that will extend certain COVID-era provisions such as such as testing, vaccination, and common disease treatments that have been a critical lifeline for millions of patients. AMCP urges lawmakers to pass the ECAPS Act to help ensure patients across the country maintain reliable access to testing and treatment for COVID-19, respiratory syncytial virus (RSV), the flu, and potential future threats to public health.