Connect with us

Finance

PBM, mental health legislation advances through Senate Finance Committee

Published

on

PBM, mental health legislation advances through Senate Finance Committee

Legislation addressing Medicare payments and mental health and pharmacy benefit managers (PBMs) advanced through the Senate Finance Committee on Wednesday in a nearly unanimous vote. 

Other than Sen. Ron Johnson (R-Wis.) who did not vote, 26 members of the panel voted to advance the package, adding to the bipartisan pressure for Congress to act on reforms to certain pharmacy intermediary business practices. 

The PBM provisions passed Wednesday build on earlier legislation the committee passed in July and will “root out middlemen tactics that drive up health costs for patients and taxpayers,” Committee Chair Sen. Ron Wyden (D-Ore.) said in a statement. 

“These measures steer America’s prescription drug market towards a state of rationality where the incentives are always to have lower costs for patients and taxpayers,” Wyden said. 

The most impactful provision in the bill would create a list of discounted drugs with high rebates in Medicare Part D where Medicare beneficiaries will pay the net price for the drug rather than the list price after patients meet their deductibles 

Advertisement

The net price includes rebates, but the list price does not. The provision aims to prevent situations where insurers are paying less to cover the drugs than patients are.  

On mental health, the legislation would require Medicare Advantage plans to keep accurate directories of providers, eliminating what Wyden called “ghost networks.” 

“Ghost networks will be a thing of the past with the consumer protections in this bill — because insurers will have to actually cover the mental health providers listed in their directories,” Wyden said.  

The legislation includes extensions of expiring Medicare and Medicaid payment provisions. It delays cuts to safety-net hospitals that treat low-income patients for two years, and it provides another year of bonus payments to physicians who move away from the practice of “fee-for-service” medicine toward value-based care. 

The bill is completely paid for, as it balances the savings from the new provisions with the cost of the extensions, making it more likely to fit into a year-end government spending bill.   

Advertisement

Copyright 2023 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Continue Reading
Advertisement
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Finance

Basel Committee Reports on Digitalisation of Finance

Published

on

Basel Committee Reports on Digitalisation of Finance
  • The Basel Committee has published a report on the implications of the digitalisation of finance for banks and supervision.
  • The report considers both the benefits and risks of new technologies and the emergence of new technologically enabled suppliers for the provision of banking services.
  • It identifies eight implications for banks and supervisors relating to macro-structural elements, specific digitalisation themes, and capacity building and coordination.

The Basel Committee on Banking Supervision published a report that considers the implications of the ongoing digitalisation of finance on banks and supervision. The report builds on the Sound Practices: implications of fintech developments for banks and bank supervisors published in 2018, and takes stock of recent developments in the digitalisation of finance.

The report reviews the use of key innovative technologies across various aspects of the banking value chain, including application programming interfaces, artificial intelligence and machine learning, distributed ledger technology and cloud computing. It also considers the role of new technologically enabled suppliers (eg big techs, fintechs and third-party service providers) and business models.

While digitalisation can benefit both banks and their customers, it can also create new vulnerabilities and amplify existing risks. These can include greater strategic and reputational risks, a larger scope of factors that could test banks’ operational risk and resilience, and potential system-wide risks due to increased interconnections. Banks are implementing various strategies and practices to mitigate these risks, but effective governance and risk management processes remain fundamental.

Digitalisation raises regulatory and supervisory implications for both banks and supervisors. These include:

  • monitoring evolving risks and adopting a responsible approach to innovation;
  • safeguarding data and implementing robust risk management processes; and
  • securing the necessary resources, staff and capabilities to assess and mitigate risks from new technologies and business models.

The Committee will continue to monitor developments related to the digitalisation of finance. Where necessary, it will consider whether additional standards or guidance are needed to mitigate risks and vulnerabilities.

Source: BIS

Advertisement

Advertisement
Continue Reading

Finance

Treasury Department to Use ‘Automation and Innovation’ to Fight Illicit Finance

Published

on

Treasury Department to Use ‘Automation and Innovation’ to Fight Illicit Finance

The Department of the Treasury has outlined the priorities it will pursue this year to step up the fight against illicit finance.

The agency aims to increase transparency, leverage partnerships and support responsible technological innovation, it said in a Thursday (May 16) press release announcing the publication of its “2024 National Strategy for Combating Terrorist and Other Illicit Financing.”

One of the Department’s priorities for the year is closing legal and regulatory gaps in the country’s anti-money laundering and combating the financing of terrorism (AML/CFT) framework, according to the release. It aims to do so by operationalizing the beneficial ownership information registry; finalizing rules covering the residential real estate and investment advisor sectors; and assessing the vulnerability of other sectors.

A second priority is promoting a more effective and risk-focused AML/CFT regulatory and supervisory framework for financial institutions, the release said. The Department will work to do so by providing clear compliance guidance, sharing information and providing resources for supervision and enforcement.

The Department also aims to enhance the operational effectiveness of law enforcement, other U.S. government agencies and international partnerships to combat illicit finance, per the release.

Advertisement

The fourth priority announced in the press release is realizing “the benefits of responsible technological innovation” by developing new payments technology, supporting the use of new mechanisms for compliance, and using automation and innovation to find new ways to fight illicit finance, the release said.

“In this critical moment for our national and economic security, we need to continue to close the pathways that illicit actors seek to exploit for their schemes,” Brian E. Nelson, Under Secretary of the Treasury for terrorism and financial intelligence, said in the release. “We recognize the threat illicit financial activity represents to our national security, economic prosperity, and our democratic values, and are focused on addressing both the challenges of today and emerging concerns.”

These recommendations are meant to address key risks the Department of the Treasury identified in February in its “2024 National Money Laundering, Terrorist Financing, and Proliferation Financing Risk Assessments.”

In another recent move, the Treasury Department said in April that it wants more tools to curb terror financing.

In testimony released ahead of an April 9 appearance before the Senate Banking Committee, Deputy Secretary Wally Adeyemo said terrorist groups and state actors continually “seek new ways to move their resources in light of the actions we are taking to cut them off from accessing the traditional financial system.”

Advertisement

For all PYMNTS B2B coverage, subscribe to the daily B2B Newsletter.


Advertisement
Continue Reading

Finance

The Great Financial Crisis kick started the private credit boom, but SVB was its true 'watershed' moment, Sixth Street co-president says

Published

on

The Great Financial Crisis kick started the private credit boom, but SVB was its true 'watershed' moment, Sixth Street co-president says

The Global Financial Crisis threw millions of Americans out of their homes and jobs, upending the entire economy. But for the private credit industry, it was actually an awakening of sorts.

Over the past few decades, U.S. banks’ problems have signaled opportunity for the private credit market, and that’s particularly true of the Global Financial Crisis and the collapse of Silicon Valley Bank last March. When banks have issues, U.S. businesses’ desire for capital rarely wanes dramatically, and that leaves room for alternate lenders.

At the Fortune Future of Finance conference on Thursday, Joshua Easterly, co-CIO and co-president of the global investment firm Sixth Street, explained how he was working at Goldman Sachs after the Global Financial Crisis in 2009, running a team that did public and private market transactions in distressed debt and special situations, when he came to the realization that the lending industry had changed forever.

“It was the intended consequence, not the unintended consequence of regulations after the Crisis,” he said of the private credit boom. “Policymakers…wanted to figure out how to diffuse risk away from the taxpayer, but you couldn’t crush the economy by reducing credit, and so private credit history grew.”

Easterly argued that the private credit industry has a “better model” than the banking industry when it comes to lending risk, because it holds more capital for loans on balance sheets. And that made him come to a startling realization in 2009. “Huh? I think I need to go find a new job,” he recalled saying to a colleague. “So [the move to private credit] was a little bit about necessity.”

Advertisement

Carey Lathrop, partner and chief operating officer of credit at Apollo Global Management, echoed Easterly’s comments, noting that when he started in the private credit industry “it was clear how hard it was to get things done that made economic sense” in public markets after the GFC.

The rise of private credit since 2008 has been historic, to say the least. Before the crisis, there was under $400 billion in total assets and committed capital in private credit. In 2023, that number jumped to $2.1 trillion, according to the International Monetary Fund. But it wasn’t just the Crisis that spurred the private credit boom. After the collapse of several regional banks in March 2023, headlined by the tech startup focused Silicon Valley Bank, businesses nationwide once again turned to private credit amid a liquidity crunch.

While SVB struggled after rapidly rising interest rates devalued its long-dated bonds, leading to a run on deposits from its list of influential and well-connected clientele, the manner in which private credit operates can lead to more stability in trying times.

Apollo’s Lathrop explained that banks like SVB “had this mismatch with a lot of long-term assets with assets with short term liabilities” that led to unrealized loan losses on their books as rates soared. But private credit doesn’t have this same issue. “We don’t run the [private credit] business that way,” he noted. “We were much more match funded.”

To his point, unlike banks, which fund a majority of their lending through customer deposits (and often uninsured deposits), private credit funds tend to use money from wealthy investors and institutions to make loans, leaving them less exposed to rising interest rates.

Advertisement

Sixth Street’s Easterly said the SVB drama essentially showed “the robustness” of the private credit] business model, leading a raft of new clientele. “I think it was a watershed moment for the value of the asset class.”

Subscribe to the CFO Daily newsletter to keep up with the trends, issues, and executives shaping corporate finance. Sign up for free.
Continue Reading

Trending