2025 brought major ACA, PBM and TPA regulatory shifts—and teams across the healthcare ecosystem felt the impact.
This episode recaps the year’s most important compliance lessons and what every organization must prepare for in 2026.
Joe breaks down the themes that defined the year: evolving CMS rules, new MPMS processes, tighter pharmacy benefit oversight, complex licensure requirements for PBMs and TPAs, and operational pressures tied to a shortened OEP. You’ll also hear how organizations approached risk adjustment, strategic market planning and data validation across the year’s episodes.
If you’re responsible for regulatory strategy, filings, licensure or ACA operations, this recap gives you the context and next steps that matter most.
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