Legislation & Regulation

Prescription digital therapeutics (PDTs) are software-based therapies shown to benefit those with mental health conditions like depression. However, many PDTs do not currently fit into one of the statutorily defined coverage categories for the Medicare or Medicaid programs, leaving beneficiaries of those programs—which include some of America’s most vulnerable populations—without access to these effective and accessible treatments. AMCP supports the Access to Prescription Digital Therapeutics Act, an important bipartisan bill that would help remedy this disparity by creating a comprehensive benefit category and expanding Medicare coverage to include PDTs.

The Ensuring Community Access to Pharmacist Services (ECAPS) Act of 2025 (H.R. 3164) is an important bipartisan bill that will extend certain COVID-era provisions such as such as testing, vaccination, and common disease treatments that have been a critical lifeline for millions of patients. AMCP urges lawmakers to pass the ECAPS Act to help ensure patients across the country maintain reliable access to testing and treatment for COVID-19, respiratory syncytial virus (RSV), the flu, and potential future threats to public health.

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.