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LATEST MEDIA

May 15, 2025
Learn more about the new executive order that is aiming to reduce drug costs by aligning with global prices. NEW EXECUTIVE ORDER AIMS TO REDUCE DRUG COSTS BY ALIGNING WITH GLOBAL PRICES On May 12, 2025, President Donald Trump issued an executive order (EO) that aims to bring the prices Americans pay for prescription drugs in line with those paid by similar nations. According to a White House fact sheet, the prices Americans pay for brand-name drugs are more than three times the price other nations pay. In April, President Trump signed another EO aimed at lowering prescription drug prices, which included a variety of directives related to the Medicare program and the pharmaceutical industry. The directives may not have an immediate impact on drug costs, as they will take time to implement. Key Directives The most recent EO outlines a number of actions intended to lower prescription drug prices in the United States. Among other things, the EO directs: - The U.S. Trade Representative and Secretary of Commerce to take action to ensure foreign countries "...are not engaged in practices that purposefully and unfairly undercut market prices and drive price hikes" in the U.S.; - The Trump administration to communicate price targets to pharmaceutical manufacturers; and - The Secretary of Health and Human Services (HHS) to establish a mechanism through which American patients can buy their drugs directly from manufacturers who sell to Americans at a "Most-Favored-Nation" price. Notably, if drug manufacturers fail to offer most-favored-nation pricing, the EO directs the Secretary of HHS to: 1. Propose rules that impose most-favored-nation pricing; and 2. Take "other aggressive measures to significantly reduce the cost of prescription drugs to the American consumer and end anticompetitive practices." This includes, but is not limited to, enforcement action by the U.S. Federal Trade Commission. Potential Legal Hurdles While the EO directs the Secretary of HHS to communicate most-favored-nation price targets to pharmaceutical manufacturers within 30 days, it is expected to face legal challenges. Industry professionals reference a similar proposal from Trump's first term, which aimed to link Medicare payments for certain medications to the lowest prices paid by other countries. This proposal was blocked by federal courts for not adhering to the notice and comment process required by the Administrative Procedure Act. Thus, the immediate impact on drug costs remains to be seen. Highlights - The EO directs HHS to communicate most-favored-nation price targets to pharmaceutical manufacturers within 30 days -The EO is expected to face legal challenges, so the immediate impact on drug costs remains to be seen Provided to you by MFC Benefits, LLC © 2025 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
May 13, 2025
Learn more about the DOL updating the Model Employer CHIP Notice and when the Prescription Drug Report is Due. DOL UPDATES MODEL EMPLOYER CHIP NOTICE The U.S. Department of Labor (DOL) has released a new model Employer Children’s Health Insurance Program (CHIP) Notice with information current as of March 17, 2025 . As a reminder, the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) imposes an annual notice requirement on employers that maintain group health plans in states that provide premium assistance subsidies under a Medicaid plan or a CHIP plan. An employer can choose to provide the notice on its own or concurrent with the furnishing of: • Materials notifying the employee of health plan eligibility; • Materials provided to the employee in connection with an open enrollment or election process conducted under the plan; or • The Summary Plan Description. An employer is subject to this annual notice requirement if its group health plan covers participants who reside in a state that provides a premium assistance subsidy, regardless of the employer’s location. The DOL’s model notice, which employers may use for this disclosure, is updated periodically to reflect changes in the states that offer premium assistance subsidies. The DOL’s model Employer CHIP Notice includes information current as of March 17, 2025. Employers could also choose to prepare their own notices or modify the model notice. Employers should be sure to include at least the minimum relevant state contact information for any employee residing in a state with premium assistance. PRESCRIPTION DRUG REPORT IS DUE BY JUNE 1, 2025 Group health plans must annually submit detailed information on prescription drug and health care spending to the federal government. This reporting is referred to as the prescription drug data collection, also known as the RxDC report. The next RxDC report is due by Sunday, June 1, 2025 , covering data for 2024. Employers should confirm they are taking steps to comply with this reporting deadline, such as providing information to third-party vendors on a timely basis. The RxDC report is comprised of several files, including those that require specific plan-level information, such as plan year beginning and end dates and enrollment and premium data. It also includes files that require detailed information about medical and pharmacy benefits. RxDC reports must be submitted through an online portal maintained by the Centers for Medicare and Medicaid Services (CMS). The agency’s RxDC website includes updated reporting instructions and other reporting resources. Employers commonly use third parties, such as issuers, third-party administrators (TPAs) and pharmacy benefit managers (PBMs), to submit RxDC reports on behalf of their health plans. Employers using third parties to submit RxDC reports must ensure that this reporting responsibility is reflected in a written agreement with the third party. Employers may work with multiple third parties to complete the RxDC report for their health plans. For example, a self-insured employer may use both its TPA and PBM to submit different portions of the RxDC report. A health plan’s submission is considered complete if CMS receives all required files, regardless of who submits them. Provided to you by MFC Benefits, LLC © 2025 Zywave, Inc. All rights reserved Download the PDF copy here. Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx Link: http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://content.zywave.com/file/b6f7a224-b3a3-4409-a8f2-953f0994d66a/Benefits%20Buzz%20Newsletter%20January%202024.docx
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