A new Center for Health & Democracy white paper reveals Palantir’s ties to major insurers, its role in Medicare’s WISeR model, and AI’s growing influence over patient care.

Staff presentation showed retail pharmacy accounted for about 16¢ of every medical dollar in 2023 and that rising price per fill — not utilization — is the main driver; presenters flagged market concentration among PBMs, vertical integration, federal legal constraints and state policy options including transparency, regulation, and state purchasing.

The Prescription Drug Affordability Board (PDAB) briefed the cost board on completed affordability reviews (Enbrel, Xtandi), its rulemaking for upper payment limits (UPLs) with potential implementation in 2028, and ongoing litigation in Colorado that temporarily blocked a UPL on a high‑cost drug.

Multiple council members raised concerns about inconsistent plan documents, possible higher out-of-pocket costs for some retirees, and the speed of the proposal; they sought written, plan-by-plan comparisons and a final plan document before implementation.

Congresswoman Del Bene and Insurance Commissioner Kuder warned that the WISER prior-authorization pilot has produced high denial rates and delayed care; the commissioner said states are coordinating complaints and will press federal and interstate oversight.

PeaceHealth officials presented the FY26 report card showing $112.6M revenue, $108.7M expenses and a $3.9M operating gain, plus $5.9M in charity care; committee members identified paragraph/table mismatches and asked for clearer definitions before adoption.

The Oregon PDAB voted to recommend additional PBM reporting and a gap analysis of state data sources, asking licensed PBMs for greater payment-flow transparency and suggesting the board study MAC list benchmarks and point-of-sale passthroughs as next steps.

A nurse from Columbia Memorial Hospital told the Health & Human Services committee that proposed downsizing to a Critical Access Hospital model would cut medical and ICU beds dramatically; she asked the county to demand data from the health system on average daily census, EMS impacts and alternatives to closing inpatient services.

Virginia Health Information (VHI) told the Joint Commission on Health Care it has modernized its website and dashboards, expanded real-time data sharing and plans to use state data to support vulnerable populations, while stressing partnership with state agencies and health systems.

Representatives of employer coalitions and the Kansas Chamber said employers and state plans lose rebate dollars when drugs are dispensed via 340B arrangements and urged that Kansas require reporting before expanding 340B access at the state level.

Federal and state officials and policy experts briefed the committee on how the 340B discount program works, HRSA's planned rebate-pilot (Jan 2027), and ongoing litigation that could shape program implementation.

HCA said it will pursue standardized credentialing and behavioral health assessment criteria aligned with ASAM, develop AI use policies, implement consistent prior authorization rules across programs, and publish payment dashboards to reduce administrative burden for providers.

Sen. Liz Bolden and others recounted that a Sutter-employed nurse joined a previous hearing by Zoom to warn that the employer did not prioritize patient care; lawmakers used the account to stress the need for enforceable protections in any merger.

The Pharmaceutical Care Management Association told the committee PBMs provide net savings and pointed to upcoming federal reporting requirements; PCMA urged caution about state rate floors and vertical integration rules that could close pharmacies in some states.

Don Dowd of Better by RX told the council that prescription benefit managers (PBMs) can conceal rebate flows and urged Richardson to publish any PBM contracts, require 100% pass-through pricing, and adopt a maximum-allowable-cost list to lower drug costs.

A consultant and data journalist described how public datasets and state audits revealed gaps between pharmacy payments and plan charges, alleging PBM practices that capture spread and later claw back overpayments under pass‑through models.

State employees, retirees and faculty urged the Public Employees Benefits Program Board to reject proposals that would raise premiums or cut benefits, calling for transparency and an independent audit of finances before any participant cost increases are adopted.

via The Hill News — Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz will announce new efforts Monday aimed at strengthening health care price transparency. The health officials will be joined by newly confirmed Labor Secretary Keith Sonderling, Deputy Treasury Secretary Francis Brooke and Federal Trade Commission Chair…

Dozens of callers and written commenters representing retired public employees and university faculty urged the board to reject options that shift costs onto retirees and employees and asked for a full independent audit of PEB finances.

Outside auditors and staff reported FY2024 PBM audit results: rebate reconciliation favored the plan and Express Scripts has paid the larger reconciliation; auditors found discount underperformance netted to a previously paid amount and identified missed service-level guarantees (mail-order, phone metrics) with penalties to be recorded.

6,654 likes, 229 comments - massnurses on September 11, 2026: "Should Jonathan Kraft be Vice Chair of the MGB Board of Directors? #Billionaire #MGB #MassNurses #HealthcareTransparency #NurseAdvocacy...

The board voted to include four primary care recommendations in its legislative report, including a goal to raise primary care spending by 1% annually toward a 12% target, renewed healthcare transaction oversight, stable state funding for primary care residencies, and support for an OIC primary care financing proposal.