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Starting January 1, 340B hospitals will pay large sums upfront to buy drugs at the full wholesale acquisition price, lawsuit says.
“Level of severity review,” which determines reimbursement, has drawn the ire of the American Hospital Association.
The inherent risks of AI necessitate ongoing oversight and governance, and physician expertise can't be substituted, AMA says.
The bill requires PBMs to be licensed and end the practice of spread pricing, among other requirements.
Thirty-four MA plans earned 5 stars in 2026 star ratings.
The legislation is endorsed by numerous healthcare groups, including the American Hospital Association.
Reliance on the “big three” PBMs – CVS Caremark, Express Scripts and Optum Rx – has been slipping over the past year.
The group says an “unchecked” model would undermine the goal of allowing safety net providers to stretch federal resources.
PBMs’ overseas group purchasing organizations may be used to avoid transparency and oversight, committee says.
The company says broad tariffs would raise costs, limit patient access and undermine domestic manufacturing.
