✦ Humana Inc. and its PBM and pharmacy subsidiaries, alongside Roche Diagnostics Corp. and Roche Diabetes Care, Inc., agreed to pay $12.5 million to settle a lawsuit that claimed they engaged in fraud and illegal kickbacks. The settlement, unveiled on Feb. 8, resolves a whistleblower’s allegations that Roche forgave millions of dollars’ worth of debt from Humana in exchange for the insurer purchasing Roche’s diabetes testing supplies and favoring them in its Medicare Advantage plan formularies. Read more at https://bit.ly/3jBVTIU.
✦ Included in House Democrats’ evolving budget-reconciliation bill for COVID-19 relief is a provision that would lift the cap on rebates in the Medicaid Drug Rebate Program. Currently, that cap is set at 100% of a drug’s Average Manufacturer Price, and proposals to increase or eliminate the cap would “generate savings for the program and lower revenues for drug manufacturers,” according to a Kaiser Family Foundation issue brief. The provision in House Democrats’ COVID-relief bill is slated to go into effect in 2023 if it makes it into the final version of the legislation. View the provision at https://bit.ly/3a8tmrb.