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WASHINGTON, D.C.  – In case you missed it, the  New York Post   recently published an article highlighting letters sent to ten states, authored by Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, and Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, inquiring about the rampant waste in their state Medicaid systems and what measures are being taken to address it. In Case You Missed It: “A House committee has launched an investigation into alleged Medicaid fraud in 10 states — including New York and California — demanding records ‘to ensure program integrity in states nationwide,’ The Post can reveal. “The letters, sent March 3 by GOP leaders on the House Energy and Commerce Committee, asked for records and communications from the governors and leaders of state health agencies of New York, California, Colorado, Massachusetts, Maine, Nebraska, Oregon, Pennsylvania, Vermont and Washington State. “Each of the missives drew attention to recent reports or prosecutions of fraudsters in the respective states. “In New York, for example, two individuals linked to adult day cares in Brooklyn and a home health care firm pleaded guilty in January to defrauding taxpayers out of $68 million in Medicaid funds. “Another scheme cited $120 million allegedly stolen from Medicaid and Medicare funds to the owners of Queens-based adult daycare centers and a pharmacy who were taking kickbacks. “The Empire State spent $115.6 billion on Medicaid for almost 7 million people in fiscal year 2025, but the program ‘has continued to grow at unsustainable levels,’ according to Gov. Kathy Hochul’s budget plan for this fiscal year. “Other letters to California, Colorado, Pennsylvania and Nebraska noted massive percentage increases in spending on Medicaid services in recent years. “‘Fraud shouldn’t be a partisan issue,’ Energy and Commerce Chairman Brett Guthrie (R-Ky.) said in a statement. ‘It’s our most vulnerable Americans who are most at risk from fraudsters diverting precious resources intended for critical, needed care.’ “‘We owe it to our fellow Americans to preserve the Medicaid program for those that need it most, and states have an important role to play in ensuring that Medicaid programs operate with integrity,’ he added. ‘The Committee will continue to combat rampant waste, fraud, and abuse across the entire country.’ “The letters all cited reports of fraudsters bilking taxpayer funds in Minnesota — as well as Trump administration probes that recently led to the withholding of more than $250 million in Medicaid funding. “That fraud was perpetrated through ‘overbilling, falsifying records, identity theft, and phantom claims in Medicaid social service and health programs for the elderly and disabled, children with autism, people struggling with substance use disorders, and homelessness,’ wrote Guthrie and two other GOP subcommittee chairmen, Rep. John Joyce (R-Pa.) and Rep. Morgan Griffith (R-Va.). “The House Energy and Commerce Committee’s probe comes after a hearing early in February that heard testimony from experts about kinds of fraud schemes — including those with ‘high rates’ of abuse such as Applied Behavioral Analysis (ABA), services for children with Autism Spectrum Disorder (ASD), substance abuse treatment centers, home and community based services and more. “Certified fraud examiner Jessica Gay told the House committee that the vulnerable programs ‘should be on every state’s radar.’ “‘If a state isn’t monitoring ABA services closely, they are likely missing a considerable area where FWA is committed,’ Gay said. “‘Medicaid fraud robs both taxpayers and patients, and we will pursue it wherever it hides,’ Joyce said in a statement. “‘Republicans in Congress will continue to do the necessary legwork to investigate allegations of waste, fraud and abuse within our Medicaid system,’ added Griffith. “New York Gov. Kathy Hochul accused the House Energy and Commerce Committee of ‘playing partisan games,’ but vowed to continue to go after ‘bad actors in the Medicaid program.’ “‘Congressional Republicans should learn from Governor Hochul’s dogged efforts to root out waste, fraud and abuse – including sweeping CDPAP reforms that shut down hundreds of wasteful Medicaid middlemen and saved over $2 billion for state and federal taxpayers while protecting home care for those who need it,’ a spokesperson for Hochul said in a statement. “A spokesperson for California Gov. Gavin Newsom insisted the state has tackled Medicaid fraud for years. “‘California holds a strong commitment to protecting taxpayer dollars and the integrity of public programs like Medi-Cal. The state has taken action against Medi-Cal fraud for years and utilizes robust oversight mechanisms to protect the integrity of Medi-Cal programs and preserve public confidence,’ the spokesperson said. “Colorado ‘takes oversight of our Medicaid programs very seriously, and prioritizes finding and rooting out fraud when it occurs, including referring to law enforcement,’ according to a statement from Gov. Jared Polis’ spokesperson. “Reps for the other seven governors’ offices and state health agencies in the states did not immediately respond to a request for comment.”

WASHINGTON, D.C. – Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, and Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, are continuing their ongoing investigation into waste, fraud, and abuse within Medicaid programs by sending letters to ten additional states to request information and documents on the actions each state is taking to strengthen Medicaid program integrity. These requests come amidst reports and law enforcement actions that have demonstrated high levels of Medicaid fraud across numerous states. For example, in Massachusetts, a woman pleaded guilty to fraudulently billing MassHealth for $500,000 in Personal Care Attendant, home health, and adult foster care services after enrolling disabled, elderly, and homeless people in services without their knowledge or consent and billing Medicaid as their caretaker despite not providing these services. In Colorado, two individuals were charged in separate cases for defrauding Health First Colorado’s non-emergency medical transportation (NEMT) program. The first defendant allegedly billed over $1 million in NEMT rides—$400,000 of which were billed for rides for herself and family members, and most of which were not associated with transportation to medical appointments. The second defendant billed Health First Colorado for $3.3 million in NEMT rides, including $283,000 for 64 rides for a single beneficiary, $165,000 of which occurred after the beneficiary had died. In Oregon, a woman was sentenced to federal prison for using stolen identities to submit fraudulent health care claims to Oregon’s Medicaid Program, totaling over $3 million and triggering $1.5 million in fraudulent Medicaid reimbursements. In New York, two individuals involved in a Brooklyn-based scheme involving adult day cares and home health  pleaded guilty   to $68 million in Medicaid fraud over a seven-year period. In addition, two men in Queens who owned adult daycare centers and a pharmacy  were recently charged  with $120 million in alleged Medicaid and Medicare fraud schemes. This included illegal kickbacks to Medicaid recipients to fill prescriptions at their pharmacies and enroll in their adult day care. It’s no secret that Medicaid fraud schemes have possibly cost the program billions of dollars annually across the country. These schemes contribute greatly to rising health care costs and strain our health care system, all at the expense of Medicaid beneficiaries and taxpayers. The Committee on Energy and Commerce is committed to rooting out waste, fraud, and abuse in our government health programs like Medicaid to ensure Americans who need them get the quality, affordable care they deserve. Chairmen Guthrie, Joyce, and Griffith issued the following statements regarding the ongoing investigation: “Fraud shouldn’t be a partisan issue. It's our most vulnerable Americans who are most at risk from fraudsters diverting precious resources intended for critical, needed care , ” said Chairman Guthrie. “ We owe it to our fellow Americans to preserve the Medicaid program for those that need it most, and states have an important role to play in ensuring that Medicaid programs operate with integrity. The Committee will continue to combat rampant waste, fraud, and abuse across the entire country.” "Medicaid was established to ensure the most vulnerable Americans are never left behind. That is why fraud and abuse within Medicaid will not be tolerated. Medicaid fraud robs both taxpayers and patients, and we will pursue it wherever it hides," said Rep. John Joyce, M.D. "Expanding this investigation is part of our responsibility in Congress to ensure that the government upholds the standards it was created to serve. Our Committee will work diligently to strengthen the integrity of the Medicaid system and to ensure that those who engage in fraudulent misuse or abuse are held fully accountable." “Americans support federal health care programs that serve American communities, not fraudsters! Led by the House Committee on Energy and Commerce, this latest series of letters is the next step in our investigations to protect our social safety net programs and secure them for the most vulnerable Americans,” said Rep. Griffith. “Republicans in Congress will continue to do the necessary legwork to investigate allegations of waste, fraud and abuse within our Medicaid system.” BACKGROUND: In January, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, Congressman John Joyce, M.D. (PA-13), Chairman of the Energy and Commerce Subcommittee on Oversight and Investigations, and Congressman Morgan Griffith (VA-09), Chairman of the Energy and Commerce Subcommittee on Health, wrote to Minnesota Governor Tim Walz and the Temporary Commissioner of Minnesota’s Department of Human Services, Shireen Gandhi, requesting communications, documents, and information to better understand the ongoing Medicaid fraud occurring in the state of Minnesota and actions the state is taking to strengthen program integrity. On February 3, the Subcommittee on Oversight and Investigations held a hearing titled Common Schemes, Real Harm: Examining Fraud in Medicare and Medicaid . During this hearing, expert witnesses testified on common examples of Medicaid fraud schemes and the potential scale of fraud in Medicaid programs nationwide. Now, as part of the Committee’s ongoing efforts to address Medicaid fraud, the Committee sent letters to CA , CO , MA , ME , NE , NY , OR , PA , VT , and WA . Each of these states displayed concerning cases of Medicaid fraud over the last several years. The purpose of this investigation is to assess the extent of fraud in state Medicaid programs and understand what states are doing to address the issue and protect the integrity of Medicaid for Americans. Read More About this Ongoing Investigation: CLICK HERE to read the New York Post's exclusive coverage of the letter.

WASHINGTON, D.C.  – Today, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, issued a statement following President Trump’s State of the Union Address to a Joint Session of Congress: “Tonight, President Trump laid out a bold vision for the American people as we celebrate the 250th anniversary since our founding. By unleashing American energy dominance, we can lower energy costs, strengthen our national security, and power innovation. As the President discussed in his speech, we must rely on baseload power from coal, oil, natural gas, nuclear, and hydropower that can provide the on-demand electricity we need. Our Committee will remain focused on cutting red tape and lowering prices for hard-working families.   “ House Republicans stand with President Trump tonight, with a strong focus on making life more affordable for everyday Americans—not only when it comes to energy prices, but when it comes to the cost of health care, too. Previous Democrat administrations effectively broke our American health care system, and I applaud President Trump in his steadfast efforts to fix it. Through programs like TrumpRx, Americans now have access to the lowest cost prescription drugs. Through commitments like Making America Healthy Again, Americans see the promise of health improvements for generations to come. Our country’s milestone of 250 years signifies an opportunity to put the wellbeing of Americans back at the forefront of our health care system.    “ As we look to the future, adversaries are challenging our standing as the world’s greatest innovator. Americans have the creativity and the skills to compete on the world stage, but we need the regulatory environment to match our aspirations. The President and I share a vision for a future where the United States can lead the development and deployment of cutting-edge technologies and Americans enjoy the benefits of these advances.   “ Tonight, the President outlined a vision of prosperity shared widely across the Republican Party. By unleashing American energy, lowering health care prices, and supporting U.S. innovators, President Trump and Committee Republicans are in lockstep fighting to address the issues that matter most to American families.”   ###

WASHINGTON, D.C. - Last December, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released a report showing that since 2016, OIG has conducted 18 audits, which revealed Medicaid agencies improperly paid states nearly $289 million on behalf of deceased enrollees. The audit outlined in HHS OIG’s report was conducted from July 1, 2021, through June 30, 2022. After reviewing a stratified random sample of 100 capitation payments from the nearly 410,000 capitation payments covered by the audit, HHS OIG found that Medicaid agencies paid for deceased individuals in 99 of the 100 sample capitation payments. During that same one-year period, Medicaid paid over $207 million to insurance companies for people who had already died. This is far from the first accounting of massive fraud found in our federal health programs. In July of 2025, the Centers for Medicare & Medicaid (CMS) announced that they had identified and were removing 2.8 million duplicative enrollees in two or more Medicaid and/or Affordable Care Act (ACA) exchange plans after conducting an analysis of 2024 enrollment data. In September of 2025, the Congressional Budget Office (CBO) found that Democrat policies have facilitated a years-long, massive cover-up to defraud American taxpayers in order to subsidize waste, fraud, and abuse in federal health programs, including using loopholes to provide free health care to illegal immigrants. The agency found that Democrat policies have led to at least 2.3 million fraudulent enrollees in Obamacare. And most recently, in December, GAO conducted covert operations by creating fictitious identities with fake or never issued Social Security numbers (SSN) and still received taxpayer-subsidized Obamacare coverage. One hundred percent of fake applicants were approved by the ACA Marketplace in late 2024 and 90 percent of fake applicants received coverage in 2025. Experts estimate the federal government may be spending as much as $27 billion a year in taxpayer dollars on improper Obamacare enrollments. Thanks to President Trump’s Working Families Tax Cuts signed into law on Independence Day last year, Republicans implemented commonsense guardrails to protect Americans and crack down on the Democrat-enabled waste, fraud, and abuse pervading our health care system. Our law takes action to remove duplicative and deceased enrollees from the Medicaid rolls and prohibit states from paying multiple managed care organizations for wasteful, duplicative health care coverage. We believe that taxpayer dollars should be used to benefit our most vulnerable Americans. To that end, the Committee has sent letters to state and federal officials requesting additional information on Medicare and Medicaid fraud. For example, the Committee opened an investigation into the massive fraud schemes in Minnesota's Medicaid programs; and just last week, our Subcommittee on Oversight and Investigations held a hearing exploring the egregious Medicare and Medicaid fraud schemes that are happening nationwide. Over the past several years, Democrat Administrations have allowed waste, fraud, and abuse across the American health care system to explode, ultimately driving up costs, hurting American families, and draining taxpayer dollars. Republicans are committed to finding solutions that restore affordability, fairness, accountability, and the rule of law across our health care system. Read the full report here .

WASHINGTON, D.C. – Congressman Morgan Griffith (VA-09), Chairman of the Subcommittee on Health, delivered the following opening statement at today’s hearing titled Lowering Health Care Costs for All Americans: An Examination of the Prescription Drug Supply Chain.

Subcommittee Chairman Griffith’s opening statement as prepared for delivery:

“First, I want to recognize the bipartisan bill that we were able to pass last week that included many important health care provisions and lowered health care costs for all Americans.

“Today, we will discuss health care costs and patient access challenges by examining affordability across the entire pharmaceutical supply chain.

“I’m proud of this subcommittee’s work, but there is still more to be done, which is why I am eager to continue building on our affordability series with today’s hearing that comes after we heard from insurance executives last month.

“We now will hear from stakeholders who are part of the complex pharmaceutical drug supply chain.

“To regular people, this system may seem simple: a disease is researched and a treatment is developed, then that treatment is manufactured and distributed to a hospital, pharmacy, or other health entity before it is dispensed to a patient.

“However, there are many more layers that are involved in this process that affect how a drug gets to a patient and how that drug is priced.

“One of the most frustrating aspects of the supply chain is that it operates in a blackbox.

“Luckily, we have witnesses here to provide their perspectives and shine a light on the process.

“Do each of these entities in front of us today play a role in getting the drug to a patient? Yes.

“Are there too many cooks in the kitchen at times? Probably so.

“Today is a great opportunity for Congress to get a glimpse and see what is happening, and look for ways to help make prescription drugs more affordable.

“In 2017, this same subcommittee held a hearing similar to this one.

“A lot has changed since then.

“I am glad we are reexamining what we learned from that hearing to continue working towards what we all want: lowering costs for patients while ensuring that America remains a leader in pharmaceutical innovation.

“We have PhRMA and BIO in front of us who can speak to the intricacies that go into researching, developing, and pricing a drug on the market.

“We will also get the perspective of generic drugs from the Association for Accessible Medicines who can speak on the issues in that area.

“We also have the Pharmaceutical Care Management Association here who is the trade association that represents pharmaceutical benefit managers, or PBMs.

“In theory, PBMs manage prescription drug benefits for insurance companies, employers, and others.

“What we heard in our hearing last month is that insurance companies own many PBMs.

“The largest three insurance owned PBMs control over 80 percent of the market.

“How they manage these benefits is a mystery and can lead to higher drug prices.

“However, just last week, led by Representative Buddy Carter from Georgia, Congress passed and the President signed into law the biggest PBM reform package in history.

“These bills will bring more transparency into this system, lower costs, and allow for more access to medicines.

“The Healthcare Supply Chain Association is here on behalf of Group Purchasing Organizations, or GPOs, which act as intermediaries between manufacturers and providers.

“In front of us is also the Healthcare Distribution Alliance, who is involved in the distribution of prescription drugs along the supply chain.

“I am looking forward to hearing from the National Community Pharmacists Association who is before us today as well, since they represent community pharmacists.

“These community pharmacies serve a critical role in bringing care to patients, especially in rural areas; yet, many have had to sadly close their doors in recent years due to factors we will discuss today.

“The ERISA Industry Committee is also here to discuss their point of view for employers when it comes to high costs, as well as decisions they make based on those costs.

“Each of these different entities play a unique role in how a drug finally gets to a patient.

“In this meeting, we will hear from these witnesses on how to navigate this complex web on behalf of the American people.

“I look forward to the discussion.”

WASHINGTON, D.C. – Today, Congressman Morgan Griffith (VA-09), Chairman of the Subcommittee on Health, led a hearing titled Lowering Health Care Costs for All Americans: An Examination of the Prescription Drug Supply Chain, featuring witness testimony from representatives across the entire prescription drug supply chain.

“I’m proud of this subcommittee’s work, but there is still more to be done—which is why I was proud to continue building on our affordability series through today’s hearing with representatives across the entire prescription drug supply chain,” said Chairman Griffith. “Hearing from these witnesses on how to best navigate this complex web helps Congress make better-informed policy decisions so that we are able to meaningfully lower the cost of care for all American patients.”

Watch the full hearing here:

Below are key excerpts from today’s hearing:

Congressman Troy Balderson (OH-12): “I represent a very rural district, and not only is access to health care a problem, but access to pharmacy services is growing more challenging as well. A 2025 FTC report examined PBM pharmacy contracting practices and found that internal PBM documents suggested rural pharmacies are often forced to accept ‘take it or leave it’ reimbursement rates. Could you elaborate on the specific challenges rural pharmacies face when negotiating contracts with PBMs, and how these practices may affect access to care in rural communities?” Mr. Hoey: “‘Take it or leave it’ contracts are part and parcel of the so-called negotiations between pharmacies and PBMs. PBMs hold all the leverage. They hold the patient lives. So, if a pharmacy does not sign whatever is put in front of them—with very little negotiation—I’m sure our friends at PMA will say there’s robust negotiation, but in reality, it’s a take-it-or-leave-it contract. These pharmacies are often forced to sign contracts that pay them below their cost to acquire the drug. And yes, rural pharmacies, as well as pharmacies in underserved areas, urban areas, and suburban communities, are all taking contracts in which they are paid below cost. As a result, 5,000 pharmacies have gone out of business in the last four years alone. That’s 5,000 fewer pharmacy choices in just four years. It’s a systemic problem. In fact, pharmacy deserts—especially in your district in Ohio and across the country—are growing because of these ‘take it or leave it’ contracts.”

Congresswoman Kat Cammack (FL-03): “Three companies control the majority of drug distribution in the United States, and many are vertically integrated to control each phase of the prescription drug supply chain—from manufacturer to pharmacy. Does consolidating the prescription drug industry lower prices for patients? Yes or no?” Mr. Davis: “It has the potential to, yes.” Congresswoman Kat Cammack: “Respectfully, your own industry report projects that the ‘big three’ will generate $871 billion in revenue this year—after four straight years of double-digit growth. So, if this is potentially saving patients money, why are revenues growing so fast, and where are patients seeing the savings?”

Congressman Michael Rulli (OH-06): “President Trump recently launched TrumpRx, a revolutionary platform aimed at bringing price transparency and competition back to the drug market. My constituents tell me every day about how much they dread going to the pharmacy because they never know what price they’re going to pay at the counter; it always changes. Then, you have brand-name versus [generic]... How have your members reacted to the transparent pricing of brand-name [drugs] on TrumpRx?” Mr. Marin: “The PBM industry is all about transparency. We are enhancing it for our customers every day, particularly for employers. The bill Congress passed a couple of weeks ago takes [transparency] to another level—we’re happy with that. We support and applaud the mission of the administration’s goal with TrumpRx.”

WASHINGTON, D.C. – This week, the House Committee on Energy and Commerce is holding one Subcommittee Hearing and two Subcommittee Markups. Read more below.

SUBCOMMITTEE MARKUP: The Energy and Commerce Subcommittee on Commerce, Manufacturing, and Trade will hold a markup of twelve bills to strengthen automotive safety, affordability, and leadership.

• DATE: Tuesday, February 10, 2026
• TIME: 10:15 AM ET
• LOCATION: 2123 Rayburn House Office Building

SUBCOMMITTEE MARKUP: The Energy and Commerce Subcommittee on Communications and Technology will hold a markup of a bill to reauthorize FirstNet.

• DATE: Tuesday, February 10, 2026
• TIME: 2:00 PM ET
• LOCATION: 2123 Rayburn House Office Building

SUBCOMMITTEE HEARING: The Energy and Commerce Subcommittee on Health is holding a hearing on exploring the role that the prescription drug supply chain plays in health care affordability.

• DATE: Wednesday, February 11, 2026
• TIME: 10:15 AM ET
• LOCATION: 2123 Rayburn House Office Building

WASHINGTON, D.C. – Today, Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, issued a statement after President Trump signed H.R. 7148 into law this week, which included the Mikaela Naylon Give Kids a Chance Act.

“H.R. 1262, the Mikaela Naylon Give Kids a Chance Act, builds on current programs to accelerate research and drug development for rare pediatric diseases, including cancer,” said Chairman Guthrie. “The bill reauthorized the Rare Pediatric Disease Priority Review Voucher Program that has led to over 50 new treatment approvals for nearly 40 different rare pediatric diseases, many of which had no treatment options prior to the existence of the program. The positive impact is profound for patients, and I am grateful to the many champions of this legislation and their commitment to promoting research and addressing gaps in pediatric therapeutics.”

Background:

• H.R. 1262, the Mikaela Naylon Give Kids a Chance Act, was reported to the full House from the Committee on Energy and Commerce, as amended, by a vote of 47 yeas and 0 nays and passed the full House by voice vote.
• H.R. 1262 was incorporated into H.R. 7148, the Consolidated Appropriations Act of 2026, which was passed by the full House on February 3, 2026, and signed into law by President Trump.

The Mikaela Naylon Give Kids a Chance Act:

• Reauthorizes the FDA Rare Pediatric Disease (RPD) Priority Review Voucher (PRV) Program through Fiscal Year 2029;
• Provides the Food and Drug Administration (FDA) with additional authority to require pediatric cancer trials for new combinations of drug therapies;
• Authorizes the FDA to take enforcement action against companies that fail to meet pediatric study requirements under the Pediatric Research Equity Act (PREA);
• Directs the FDA to establish an office in an Abraham Accord country to enhance facilitation with the agency; and
• Requires FDA to disclose to certain generic drug applicants if any ingredients cause a drug to be quantitatively or qualitatively different from the listed drug, speeding up patients access to more affordable medications.

WASHINGTON, D.C. – Just one day after President Trump signed into law the most comprehensive pharmacy benefit manger (PBM) reform in American history, the Federal Trade Commission (FTC) reached a historic settlement with one of the nation’s largest PBMs, Express Scripts, Inc., along with affiliated entities (ESI collectively), requiring them to change current business practices to drive down drug costs for patients and employers.

The settlement directly addresses many of the harmful pharmaceutical middlemen practices that the House Committee on Energy and Commerce has called attention to for years and supports a key commitment of President Trump’s new health care agenda, The Great Healthcare Plan, to lower prescription drug prices.

Congressman Brett Guthrie (KY-02), Chairman of the House Committee on Energy and Commerce, issued the following statement:

“This week has marked many successes when it comes to transparency and affordability of prescription drugs for American patients,” said Chairman Guthrie. “The House Committee on Energy and Commerce supports President Trump’s efforts and will continue this work by calling in representatives across the entire prescription drug supply chain next week to continue our commitment to lowering the cost of care for all Americans. This is just another way Republicans are working to implement meaningful relief for American families when it comes to health care affordability.”

Background:

ESI, under the FTC’s proposed consent order, has agreed to:

• Stop preferring on its standard formularies high wholesale acquisition cost versions of a drug over identical low wholesale acquisition cost versions;
• Provide a standard offering to its plan sponsors that ensures that members’ out-of-pocket expenses will be based on the drug’s net cost, rather than its artificially inflated list price;
• Provide covered access to TrumpRx as part of its standard offering upon relevant legal and regulatory changes;
• Provide full access to its Patient Assurance Program’s insulin benefits to all members when a plan sponsor adopts a formulary that includes an insulin product covered by the Patient Assurance Program unless the plan sponsor opts out in writing;
• Provide a standard offering to all plan sponsors that allows the plan sponsor to transition off rebate guarantees and spread pricing;
• Delink drug manufacturers’ compensation to ESI from list prices as part of its standard offering;
• Increase transparency for plan sponsors, including with mandatory, drug-level reporting, providing data to permit compliance with the Transparency in Coverage regulations, and disclosing payments to brokers representing plan sponsors;
• Transition its standard offering to retail community pharmacies to a more transparent and fairer model based on the actual acquisition cost for a drug product plus a dispensing fee and additional compensation for non-dispensing services;
• Promote the standard offerings to plan sponsors and retail community pharmacies; and
• Reshore its group purchasing organization Ascent from Switzerland to the United States, which will bring back to the United States more than $750 billion in purchasing activity over the duration of the order.
• The settlement is projected to ** save American patients $7 billion ** in out-of-pocket costs for prescription drugs over a decade.

Click HERE to read the full settlement.