New Drug Price Transparency Rule for Health Insurers: Disclosures, Enforcement, Compliance, Antitrust

A live 90-minute CLE video webinar with interactive Q&A

This program is included with the Strafford CLE Pass. Click for more information.
This program is included with the Strafford All-Access Pass. Click for more information.

Tuesday, March 8, 2022

1:00pm-2:30pm EST, 10:00am-11:30am PST

Early Registration Discount Deadline, Friday, February 18, 2022

or call 1-800-926-7926

This CLE course will review the interim final rule requiring commercial health insurance issuers and health plans in the group and individual markets to submit to the government information about prescription drug and healthcare spending, including information regarding prescription drug rebates, fees, and other remuneration. The panel will discuss the pivotal provisions of the interim final rule, best practices to promote compliance, and competitive market considerations.

Description

The Consolidated Appropriations Act of 2021 (CAA) requires insurance issuers and plans in the group and individual markets to begin submitting to the government information about prescription drug and healthcare spending, including information regarding prescription drug rebates, fees, and other remuneration, by Dec. 27, 2021, and June 1 of each year thereafter.

On Nov. 17, 2021, the Departments of Health and Human Services (HHS), Labor (DOL), and Treasury, plus the Office of Personnel Management (OPM), released an interim final rule with request for comments entitled "Prescription Drug and Health Care Spending," implementing these requirements.

These legislative and regulatory changes impact insurers, manufacturers, and other supply chain intermediaries such as pharmacy benefit managers since they require an enhanced level of drug pricing-related disclosure– including the disclosure of rebates and other information that many market participants have historically considered to be proprietary and highly confidential.

The interim final rule also imposes significant reporting requirements and new mandates on insurers in the individual and small group markets and noteworthy penalties for failure to comply.

Many critical provisions may create confusion and must be carefully parsed to understand their application.

Listen as this panel guides attendees through what the new regulations require and best strategies for avoiding enforcement. Furthermore, the panel will explore broader trends around price transparency and what these trends may mean for competitive market players, who now may have access to new, competitively-sensitive pricing information.

READ MORE

Outline

  1. Critical provisions of the interim final rule
  2. Key disclosures
  3. Enforcement authority
  4. Competitive market and antitrust considerations related to price disclosures
  5. Best practices and next steps for insurers

Benefits

The panel will review these and other notable issues:

  • What are the key provisions of the interim final rule?
  • When will enforcement begin?
  • How will the disclosures affect the costs of services and prescription drugs?
  • What are key competitive market implications of disclosing certain price information?What are the next steps and best practices to comply with the rule?

Faculty

Hall, Margaux
Margaux J. Hall

Partner
Ropes & Gray

Ms. Hall is a leading lawyer in drug pricing, managed care and value-based payment arrangements. She brings to clients...  |  Read More

Young, David
David Young

Senior Attorney
Ropes & Gray

Mr. Young is a senior attorney in Ropes & Gray’s antitrust practice group. He represents a variety of...  |  Read More

Attend on March 8

Early Discount (through 02/18/22)

Cannot Attend March 8?

Early Discount (through 02/18/22)

You may pre-order a recording to listen at your convenience. Recordings are available 48 hours after the webinar. Strafford will process CLE credit for one person on each recording. All formats include course handouts.

To find out which recorded format will provide the best CLE option, select your state:

CLE On-Demand Video

Download