C-Suite

In a lawsuit filed in September 2024, the FTC alleged that CVS Caremark, along with Express Scripts and OptumRx, used rebate systems that favored higher-cost drugs, driving up list prices and out-of-pocket costs for patients.

The cost-of-living adjustment for 2027 is still expected to be higher than this year's.

A federal judge has dismissed with prejudice a lawsuit accusing medical billing company HaloMD and two physician groups of defrauding Blue Cross Blue Shield of Georgia through the No Surprises Act's independent dispute resolution process, marking the latest court to reject insurers' efforts to challenge arbitration outcomes through separate litigation.

"Access to quality care at an affordable price remains a significant challenge for millions of Americans, underscoring the importance of making strategic and personalized benefit decisions," eHealth CEO Derrick Duke said.

Across all payer types, formulary rejections were common, increased substantially over time and frequently resulted in delayed or no dispensing of the prescribed drug or another medication in the same therapeutic class.

Agreement clears a key hurdle for Omnicare's Chapter 11 reorganization and planned sale after last year's nearly $949 million fraud judgment.