PBM industry: feds change the oversight regulations and THEY MOVE THE GOAL POST

Feds to Stop #Pharma ‘Rebates’ to #PBMS, But President Biden Delays.

The Department of Health and Human Services #Removed the ‘Safe Harbor’ Protection from the #AntiKickback Statute for Drug Rebate Payments to PBMs.

**Note Trump Initially Put New Regulation in Place and Biden Has Delayed it Until 2023.

In Other Words, Drug Companies Must Stop Giving Their Rebate Payments to PBMs and Give them Directly to #Seniors on #Medicare Instead.

A Study Estimates that These Rebate Payments to Seniors Would #Save Them $381 – $1,522 Per Person Per Year.

To Potentially Circumvent This Regulatory Change, the PBM Express Scripts (Now Part of Cigna) Started a Group Purchasing Organization (#GPO) Called Ascent Health Services that is Based in Switzerland.


Reason: Pharma Companies Can Still Pay ‘Administrative Fees’ (in place of Rebates) to the PBM’s GPO Because GPOs Are Still Protected Under #SafeHarbor from the Anti-Kickback Statute.

@CVS Has Started Their Own GPO Called Zinc as Well.

#InsuranceCarriers and PBMs DO NOT Need to Follow These New Regulations When It Comes to Their Employer Clients and their Employee Health Plans–the Rebate Payments to PBMs Can Remain. 

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