• California: Three independent pharmacies have separately sued GoodRx for allegedly conspiring with several pharmacy benefit managers (PBMs) to fix reimbursement fees to favor pharmacies associated with the PBMs themselves. According to the lawsuits, GoodRx and some of the largest PBMs have coordinated their reimbursement policies to deliberately reduce reimbursement fees for certain pharmacies. The "anti-competitive" tactic has contributed to financial difficulties for a growing number of independent pharmacies, the lawsuits said. "The upshot of this scheme is that the conspiring PBMs, by coordinating their reimbursement decisions through GoodRx, never pay pharmacies more for generic drugs than any rival PBM has agreed to pay in its separate negotiations with those pharmacies," said Community Care Pharmacy in its lawsuit. "This is nothing more than price fixing." Other independent pharmacies that have filed lawsuits include Keaveny Drug and Old Baltimore Pike Apothecary. (Silverman, STAT+ [subscription required], 11/5)
• District of Columbia/Illinois: The American Hospital Association (AHA) and FBI have partnered on new resources to help hospitals reduce violence in healthcare settings. "The problem of physical security in a hospital is incredibly complex, because you have to have access to the general public. You have to allow people in and out," said Scott Gee, AHA's deputy national advisor for cybersecurity and risk. "It's difficult to determine who's a threat and who's not." At the same time, Congress is currently considering a bill that would give health providers federal protections against attacks and make it a crime to attack a healthcare worker. Federal regulators are also expected to propose new standards to prevent workplace violence in healthcare settings in December. (Goldman, Axios, 10/30; American Hospital Association, 10/22)
• Texas: Under an order from Gov. Greg Abbott (R), hospitals in Texas are now required to ask patients whether they're in the country legally and track the cost of treating people without legal status. According to the Associated Press, a similar policy went into effect in Florida last year. Critics of the mandate say they are worried the mandate could scare people away from hospitals in Texas. However, patients are not required to answer the question to receive medical care, and the information submitted to state health officials does not include patient names or personal information. Both immigrant and healthcare advocates have worked to educate the Texas public about their right to receive care. Healthcare providers have also received directives from the state and guidance from the Texas Hospital Association (THA). "The bottom line for patients is that this doesn't change hospital care. Texas hospitals continue to be a safe place for needed care," said THA spokesperson Carrie Williams. (Associated Press, 11/1)

Pharmacy benefit managers (PBMs) play a key role in the U.S. health benefits landscape by facilitating pharmacy transactions and implementing strategies to lower pharmacy costs for insured individuals and their plan sponsors. PBMs must balance this objective with the drive to grow revenue and increase shareholder value. Understand the top strategies pharmacy benefit managers (PBMs) are pursuing to grow revenue while lowering pharmacy costs for insured individuals.