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# CMS publishes the Part D "reasonable and relevant" contract terms RFI
- URL: https://members.americanhealthintel.com/2026-09-26-serviceline/
- Published: 2026-09-26T23:52:06.000Z
- Updated: 2026-09-26T23:52:06.000Z
- Description: Plus: Merck restricts 340B covered entities to one contract pharmacy starting Oct 1. The day's rules, money, and enforcement, sourced and tiered below.
- Author: American Health Intel

Plus: Merck restricts 340B covered entities to one contract pharmacy starting Oct 1\. The day's rules, money, and enforcement, sourced and tiered below.

| American Health Intel Rules · Money · Medicine · Decoded daily The Service Line Saturday, September 26, 2026 CMS publishes the Part D "reasonable and relevant" contract terms RFI Plus: Merck restricts 340B covered entities to one contract pharmacy starting Oct 1\. The day's rules, money, and enforcement, sourced and tiered below. ![](https://americanhealthintel.com/email/pulse-divider.png) Record The Medicare drug-plan middlemen fight just got its rulebook: CMS is asking the pharmacy industry to define what a "fair" contract between a pharmacy benefit manager and a pharmacy actually looks like. CMS published the formal request for input September 24\. Comments are due November 23\. Whatever standards result will bind Part D pharmacy network contracts starting the 2028 plan year, effective January 1, 2029. Record A drugmaker just showed hospitals how little a winning lawsuit protects them: Merck is cutting most 340B hospitals down to one contract pharmacy each, even in states where courts have upheld pharmacy-access laws. Merck's September 23 notice takes effect October 1\. A hospital without its own outpatient pharmacy gets one designated contract pharmacy, and a wholly owned one only qualifies within 40 miles of the hospital. Also today Biosimilars now drive 23% of wholesaler profit from just 6% of revenue [Read](https://americanhealthintel.com/editions/2026-09-26-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#wholesaler-biosimilar-profit-mso-integration) Medicare's GLP-1 Bridge program hits \~600K enrollees, 15% of the eligible pool [Read](https://americanhealthintel.com/editions/2026-09-26-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#medicare-glp1-bridge-program) Over 80% of hospitals report a shortage of experienced pharmacy technicians [Read](https://americanhealthintel.com/editions/2026-09-26-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition#pharmacy-technician-workforce-shortage-2024-survey) 720Records$38.9BEnforcement32Deadlines186Rules [Read this issue + the trackers](https://americanhealthintel.com/editions/2026-09-26-serviceline/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) Pick your field on the site and every story tells you what it means for you. Reply to this email and tell us what you want covered. We read everything. We show our work. We score our own calls. [Track record](https://americanhealthintel.com/ledger/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [Calendar](https://americanhealthintel.com/calendar/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [Enforcement](https://americanhealthintel.com/enforcement/?utm%5Fsource=newsletter&utm%5Fmedium=email&utm%5Fcampaign=edition) · [X](https://x.com/amhealthintel?ref=members.americanhealthintel.com) · [LinkedIn](https://www.linkedin.com/company/american-health-intel?ref=members.americanhealthintel.com) News and analysis, not legal, medical, coding, or investment advice.You subscribed at americanhealthintel.com · [Unsubscribe](%%{unsubscribe%5Furl}%%) |
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