CVS (US)


August 18, 2025

[CVS, CI, UNH, ELV]: CA’s PBM Reform Bill Appears Next Up in PBM Fight

By Beth Steindecker

With California’s legislature coming back Monday from its summer recess for its final few weeks of the regular session, pharmacy benefit manager (PBM) legislation is still on the docket and likely to invite headline risk…

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August 7, 2025

Health Insurer / Provider Legislative Agenda: Band-Aid Likely in September CR, More Substantial Package Potentially Later in the Year

By Beth Steindecker

With the August recess in full swing for the next few weeks, the various healthcare-related legislative items on Congress’s to-do list (see below) remains lengthy for the rest of the calendar year. We are still…

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July 28, 2025

CY26 Medicare Part D: Additional Spending but CMS Starting to Put on the Brakes

By Beth Steindecker

Today’s CMS release regarding its CY26 Medicare Part D program gives  the impression the agency is focusing on stability in its drug benefit program with the goal to ensure 1) enrollees – especially those in…

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July 2, 2025

Medicare Advantage RADV Update: Tons More PY19 Audits, UNH Has the Most For Now

By Beth Steindecker

CMS’s addition last week of 300+ Medicare Advantage (MA) [UNH, HUM, CNC, ELV, CVS, ALHC] contracts to be audited for risk adjustment data verification (RADV) during plan year (PY) 2019 raises the risk of larger…

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June 16, 2025

Medicare Advantage: Filling in RADV Blanks; HUM Has Most Contracts Targeted [HUM, UNH, CVS, ELV, CNC, ALHC]

By Beth Steindecker

Late Friday, CMS announced the latest list of Medicare Advantage (MA) contracts to be targeted for risk adjustment data verification (RADV) audits – this time for payment year (PY) 2019 – and its associated processes…

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June 13, 2025

PBMs: State Legislative Risks Persist Through Session Ends [CI, CVS, UNH, HUM, ELV, Navitus]

By Beth Steindecker

With many 2025 state legislative sessions having concluded, pharmacy benefit managers (PBMs) have – for the moment – successfully avoided various bills seeking to aggressively curb industry practices, except for a few new laws in…

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May 21, 2025

Medicare Advantage: Ramping Up RADV Audits Clearly a Threat, But Does It Head Off Other Risks? [HUM, UNH, CVS, ELV, ALHC]

By Beth Steindecker

CMS’s announcement late Wednesday to turn the dial up on its risk-adjustment data verification (RADV) audits of Medicare Advantage (MA) contracts with an eye toward the entire landscape raises legitimate fears of recouping sizable past…

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May 13, 2025

[ELV, CNC, MOH, UNH, CVS] CMS Managed Care Provider Tax Proposal

By Beth Steindecker

Yesterday’s CMS proposal confirms our suspicion that the agency would seek to tighten state provider taxes – primarily those on managed care [ELV, UNH, CNC, MOH, CVS, CI, OSCR]– used to secure sizable federal Medicaid…

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May 7, 2025

PBMs: Death by a Thousand Cuts? [CI, CVS, UNH, ELV, GDRX]

By Beth Steindecker

The list of potential state and federal legislative threats to pharmacy benefit managers (PBMs) [CI, CVS, UNH, ELV, GDRX] seems to be growing, even though there has not been widespread enactment of these bills. Putting…

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April 10, 2025

[CVS, CI, UNH]: Senate Confirmation of 3rd FTC Commissioner Allows for Future Resumption of PBM Litigation

By Beth Steindecker

Today’s successful Senate confirmation of Mark Meador to join the FTC as a commissioner paves the way for the FTC to officially resume its antitrust litigation against the pharmacy benefit managers (PBMs) [CVS, CI, UNH,…

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