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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A photo of vaccines, syringes and needles

ACIP Sign-on Letter

As mostly non-pediatric organizations representing public health, older adults, patients, family caregivers, consumers and healthcare workers, we support everyone having access to every vaccine they need, regardless of their age. In the United States alone, routine childhood vaccinations for children born between 1994 and 2023 are projected to prevent about 1.13 million deaths, and hundreds of millions of illnesses and hospitalizations. Put simply, childhood vaccines make healthy adults.
Legislation & Regulation
AMCP Regulatory NewsBreaks

Regulatory NewsBREAK: CMS Releases the Maximum Fair Price (MFP) for Selected Drugs for IPAY 2027

On November 25, 2025, the Centers for Medicare & Medicaid Services (CMS) released the maximum fair price (MFP) for each of the 15 selected drugs for IPAY 2027, which will go into effect beginning January 1, 2027. These negotiated prices reflect a marked increase in savings compared to the initial 2026 cohort, influenced by newer drugs and expanded pricing benchmarks.
Legislation & Regulation
Capitol Behind Trees

Federal Update: Senators Reach Deal to End Shutdown

On Sunday, November 9, Senate Majority Leader Thune announced that he had reached an agreement with a group of 8 Democratic senators and the White House on a deal to end the longest shutdown in U.S. history. On Monday, November 10, the Senate approved the government funding bill by a vote of 60-40, which sends the legislative package back to the House of Representatives.
Legislation & Regulation
AMCP Regulatory NewsBreaks

Regulatory NewsBREAK: CMS Releases the GENEROUS Model (Generating Cost Reductions for U.S. Medicaid Model)

On November 6, 2025, the Centers for Medicare & Medicaid Services (CMS) released the GENEROUS Model (Generating Cost Reductions for U.S. Medicaid Model). The model aims to achieve Most Favored Nation (MFN) international pricing for Covered Outpatient Drugs (CODs) while maintaining or improving the quality of care for Medicaid beneficiaries.
Legislation & Regulation
AMCP Regulatory NewsBreaks

Regulatory NewsBREAK: CMS Releases the GENEROUS Model (Generating Cost Reductions for U.S. Medicaid Model)

On November 6, 2025, the Centers for Medicare & Medicaid Services (CMS) released the GENEROUS Model (Generating Cost Reductions for U.S. Medicaid Model). The model aims to achieve Most Favored Nation (MFN) international pricing for Covered Outpatient Drugs (CODs) while maintaining or improving the quality of care for Medicaid beneficiaries.
Legislation & Regulation
Capitol Behind Trees

Federal Update: Trump Administration Announces Deal to Bring Most-Favored-Nation Pricing to GLP-1s

President Donald Trump announced a series of agreements with Eli Lilly and Company and Novo Nordisk to offer Most-Favored-Nation (MFN) prices on two GLP-1 therapies, semaglutide (brand names Ozempic and Wegovy) and tirzepatide (brand names Mounjaro and Zepbound). This marks the fourth and fifth publicly announced agreements between the Trump administration and pharmaceutical manufacturers, joining earlier announcements with Pfizer, AstraZeneca, and EMD Serono. The manufacturers also agreed to cap prices for insulin products and other commonly prescribed diabetes medications.
Legislation & Regulation
Sacramento Capitol Building CA SB 966

Legislative Update: California Governor Signs PBM Reform Bill

On Saturday, October 11, Governor Gavin Newsom signed SB 41, a bill that limits certain business practices employed by pharmacy benefit managers (PBMs) in California. This bill follows previous attempts by the governor to regulate PBMs, including changes implemented in the budget that require PBMs to obtain a license, submit detailed operational and financial statements annually to the Department of Managed Health Care, and act in the best interests of health plans and covered individuals.
Legislation & Regulation
AMCP Regulatory NewsBreaks

Regulatory NewsBREAK: CMS Issues Final Guidance on Medicare Drug Price Negotiation Program

On September 30, 2025, the Centers for Medicare and Medicaid Services (CMS) issued final guidance for the third cycle of the Medicare Drug Price Negotiation Program for Initial Price Applicability Year (IPAY) 2028. Negotiations for the Maximum Fair Prices (MFP) on up to 15 additional negotiation-eligible Part D and/or Part B drugs will occur in 2026, with the MFP effective in IPAY 2028.
Legislation & Regulation