Regulatory Updates

 

 

Letters, Statements, and Analysis

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NYS Capitol

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.
Government/Legal Affairs
Capitol Hill, U.S. Capitol, IRA Workshop

AMCP Comments on the 2025 Medicare Physician Fee Schedule

On September 9, AMCP submitted comments praising CMS’s proposal to cover Digital Mental Health Treatment devices (DMHTs) under Medicare Part B. AMCP urges CMS to use its authority to cover all FDA-cleared, prescription only digital health products and develop appropriate coding and payment methodologies to promote adoption of these innovative technologies.
Medicare