Legislation & Regulation

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.

The Access to Prescription Digital Therapeutics Act of 2023 will help ensure that the greatest number of patients possible are receiving innovative, modern care, which is especially vital for closing care gaps caused by specialist shortages or geographic obstacles. View the issue brief to learn more.

The Academy of Managed Care Pharmacy (AMCP) thanks the Department of Health and Human Services, the Department of Labor, and the Department of the Treasure (collectively, the Departments) for the opportunity to provide comments in response to the proposed rule titled “Enhancing Coverage of Preventive Services Under the Affordable Care Act [CMS 9887–P]” published in the Federal Register on October 28, 2024.

Our Associate Vice President of Congressional Affairs Adam Colborn unpacks the key issues the health policy community should be on watch for when preparing for the incoming presidential administration in a recent article for First Report Managed Care.

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.