National - US HR9096 was introduced in the United States House of Representatives. HR9096 is part of a broad effort to increase the affordability and transparency of prescription drugs in the United States. HR9096 would allow pharmacy payment and reimbursement by Pharmacy Benefit Managers (PBMs). The bill aims to do this through implementing standardized payment models, transparency requirements, and regulatory oversight.
MyMatrixx by Evernorth released the Helping Heroes Fight Cancer The Importance of Monitoring Cancer Presumptions and Managing Treatment Costs report. This report explains how Pharmacy Benefit Managers (PBMs) play a role in monitoring the growing trends of presumptions and their impact. To read the report, click here.
Late last week, NCCI released two reports, the Quarterly Economic Briefing Q2 2024 and the Medical Inflation Insights July 2024 report. The quarterly report found that medical inflation remains a top concern. The Medical Inflation Insights July 2024 report provides a quarterly summary of the latest trends and analysis of the factors influencing price changes and their potential effect on workers' compensation. The report found workers' compensation weighted medical price index was +3% where Physician Care was +1.8% and Hospital Care was +4.7%.
DC – The Office of the Attorney General revealed a $3.75 million settlement, marking the most substantial recovery in workers’ rights enforcement in DC. Power Design along with its general contractor John Moriarty & Associates of Virginia and several labor brokers were sued for wrongly categorizing several construction workers as independent contractors rather than employees, allowing companies to not pay for sick leave or payroll taxes. The settlement states Power Design will pay $3.75 million total, including $1.7 million in restitution over 1,200 construction workers who were either misclassified or denied paid sick leave.
Massachusetts –
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- MA S2520 passed the House this week. S2,520, also known as the Pharmaceutical Access and Transparency (PACT) Act, aims to improve transparency, cost, and access to pharmaceutical drugs.
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- This week MA S2898 was introduced in the Senate. MA S2898 aims to improve access to harm reduction services and help individuals struggling with substance use disorders. Specifically, the bill would mandate coverage for opioid antagonists (naloxone) and ensure coverage for services from licensed recovery coaches.
Michigan - Workers’ Compensation Research Institute (WCRI) released its 17 State Study Group. The study found Michigan has the lowest average cost per workers’ compensation claim among the 17 states analyzed, with an average expense of $31,735 per claim. The 16 other states in the study are Arkansas, California, Florida, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Minnesota, New Jersey, North Carolina, Pennsylvania, Tennessee, Texas, Virginia, and Wisconsin.
Illinois - CVS Caremark, the Pharmacy Benefit Manager (PBMs) operation under CVS Health, will pay $45 million in missed rebates. The state of Illinois settled a lawsuit arguing Caremark failed to pass through manufacturer rebates over a four-year contract period. To learn more, check out Drug Topics article.
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