Policy & Community Health
Healthcare Policy Developments
Factual, balanced coverage of policy developments that affect pharmacy practice.
Healthcare Policy Developments at a glance
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- Factual, balanced coverage of policy developments that affect pharmacy practice.
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- Tracked from official sources on PBMs & reimbursement, GLP-1 pricing, coverage & access, Drug advertising & marketing enforcement and Telehealth prescribing & medication delivery.
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- PBMs & reimbursement
- GLP-1 pricing, coverage & access
- Drug advertising & marketing enforcement
- Telehealth prescribing & medication delivery
- Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; and Quality Reporting Programs; including the Hospital Outpatient Quality Reporting Program and Ambulatory Surgical Center Quality Program; Request for Information on Strengthening the Standardization and Comparability of Hospital Price Transparency (HPT) Data; Prior Authorization; Accrediting Organization (AO) Deeming for Emergency Medical Treatment and Labor Act (EMTALA); and Notices of Cl (opens the source in a new tab)
This final rule with comment period revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) payment system for calendar year 2027 based on our continuing experience with these systems. We also describe the ch…
- Improving Transparency Into Pharmacy Benefit Manager Fee Disclosure (opens the source in a new tab)
The Department is issuing a final regulation that will require providers of pharmacy benefit management services and affiliated providers of brokerage and consulting services to disclose information about their compensation to fiduciaries of large, self-insured group health pl…
- Medicare Program; Implementation of Sections 6219, 6220, and 6224 of the Consolidated Appropriations Act, 2026 (opens the source in a new tab)
This proposed rule would implement section 6219 (Adjustments to Medicare Part D Cost-Sharing Reductions for Low-Income Individuals), section 6220 (Requiring Enhanced and Accurate Lists of (REAL) Health Providers Act), and section 6224 (Modernizing and Ensuring Pharmacy Benefit…
- [Core data set telemedicine in intensive care medicine. Requirement catalogue via Delphi study] (opens the source in a new tab)
- Request for Information (RFI): Pharmacy Benefit Manager Compensation and Data Collection (opens the source in a new tab)
This request for information (RFI) solicits technical input on the services and business practices of pharmacy benefit managers ("PBMs") and their affiliates to inform implementation of recent legislation. It specifically focuses on gathering information to inform two specific…
- Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications (opens the source in a new tab)
The Drug Enforcement Administration (DEA) jointly with the Department of Health and Human Services (HHS) is issuing a fourth extension of telemedicine flexibilities for the prescribing of controlled medications through December 31, 2026.
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