Federal Healthcare Rules and PBM Proposals Target Drug and Care Costs

Finalized White House rules lower Part B payment rates for certain outpatient drugs tied to 340B hospitals and apply site-neutral payment to routine imaging, with changes expected in 2027 and effects still uncertain. Fall 2026 PBM coverage adds proposed insulin and rebate measures, broker-kickback restrictions, data-access requirements, and limits on vertical integration, as well as CMMI drug-pricing models and a GLP-1 Bridge Program; proposals and models should not be confused with enacted law.