The U.S. Supreme Court recently ruled against Pharmacy Benefit Managers (PBMs), scoring a win for smaller, independent pharmacies. The opinion by the high court will allow states to regulate how much money PBMs are required to reimburse pharmacies for prescription medication. On December 10, 2020, in Rutledge v. Pharmaceutical Care Management Assn., the Supreme Court…

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Pharma giant Biogen Inc. has become the most recent company to resolve allegations that it violated the False Claims Act by illegally using two charities to pay the co-pays of Medicare patients taking its multiple sclerosis drugs, Avonex and Tysabri. The U.S. Department of Justice announced earlier this month that the Cambridge, Mass.-based company agreed…

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The U.S. Department of Health and Human Services Office of Inspector General and Centers for Medicare & Medicaid Services recently published long-awaited final rules that significantly reform regulations interpreting the federal Stark Law and Anti-Kickback Statute. The agencies have stated that the changes “aim to reduce regulatory barriers to care coordination and accelerate the transformation…

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