Welcome to another weekly roundup of critical updates in healthcare policy and medicine. This Week in Policy and Medicine top stories feature significant legal battles, government actions, and valuable insights into compliance strategies that are shaping our industry.
Express Scripts Takes Legal Action Against FTC
Express Scripts has filed a lawsuit against the Federal Trade Commission (FTC), claiming defamation following a recent FTC report. The pharmacy benefit manager argues that the report contains misleading information that harms its reputation and misrepresents its business practices. This case could have significant implications for regulatory approaches and oversight of PBMs in the future. Read more about this case here.
BCBS Settles Antitrust Lawsuit for $2.8 Billion
Blue Cross Blue Shield (BCBS) has reached a landmark $2.8 billion settlement to resolve antitrust allegations. The allegations claimed that BCBS engaged in anti-competitive practices that restricted competition and increased healthcare costs. This settlement marks one of the largest in healthcare antitrust enforcement. Find out more about the settlement.
DOJ’s Aggressive Crackdown on Healthcare Fraud
The Department of Justice (DOJ) has successfully resolved over $1 billion in False Claims Act settlements in the first half of 2024. These settlements primarily involved healthcare companies accused of defrauding federal health programs, underscoring the government’s continued focus on combating healthcare fraud. Learn more about these cases.
Senate Report Criticizes MA Insurers
A recent Senate report accuses Medicare Advantage (MA) insurers of denying necessary patient care to boost profits. The report calls for stricter oversight and reforms to ensure that MA plans provide appropriate care to their enrollees. Read the full report and its implications.
Trump Administration Considers DTC Ban
The Trump administration is considering a ban on direct-to-consumer (DTC) pharmaceutical advertising, a move that could drastically alter the landscape of medical communications. This potential policy shift raises important questions about free speech, public health information, and pharmaceutical marketing practices. Explore the potential implications.
Inspiring Integrity: Winning with Compliance
A recent article on Policy and Medicine outlines how companies can enhance performance by prioritizing compliance. The piece offers strategies for integrating ethical practices into business models, thereby fostering a culture of integrity that aligns with long-term success. Discover how to propel performance through compliance.
Stay informed and ahead of the curve in the ever-evolving landscape of policy and medicine. For more discussions on these topics, listen to This Week in Policy and Medicine Podcast, available on Spotify and other podcast platforms.