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Denise guides health insurers and managed care organizations through their highest priority regulatory compliance challenges and strategic transactions, including mergers and acquisitions, joint ventures, and developing new business models where payors and providers converge.

On January 22, the U.S. House of Representatives passed on a bipartisan basis HR 7148, the Consolidated Appropriations Act, 2026 (HR 7148). If it also wins passage in the Senate, the bill would, among other Trump administration priorities, impose new rules and requirements for pharmacy benefit managers (PBMs) and pharmacy benefit administration more generally. As with prior federal legislative proposals, HR 7148 attempts to bring more transparency to the administration of pharmacy benefits for both fully insured and self-funded groups and would impose enhanced transparency requirements for PBMs contracting with Medicare Part D prescription drug plans PDP sponsors. Specifically, among other requirements, HR 7148 proposes the following new rules and regulations impacting PBM arrangements:Read More House Passes HR 7148, Advancing New PBM Transparency and Compensation Rules

Since the Fall of 2017, the Trump Administration has used its executive and regulatory authority to roll back coverage requirements for Affordable Care Act[1] (ACA) health plans and expand access to association health plans that would be offered outside of ACA’s exchanges to small businesses and self-employed individuals. In response
Read More Medicare Part E for All – An Idea Whose Time, Perhaps, Has Still Not Come