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Employer Issues


Another Dispatch From the Accumulator-Maximizer Wars
Vanderbilt’s Stacie Dusetzina and colleagues explain how the ‘copay adjustment’ programs work in this week’s JAMA Internal Medicine and...
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Jun 9, 20233 min read


PUTT Blog | Bravo to American Pharmacy Cooperative, Inc. for Calling On “Big 3” PBMs’ Largest Investor to Use Its Influence To Restrain PBM Economically Damaging Practices
This week American Pharmacy Cooperative, Inc. (APCI) took a bold step in the ongoing campaign for PBM reform: they openly called on Vanguard Inc., the largest investor of in the parent companies of the “Big 3” pharmacy benefit managers (PBMs), to use its influence to curtail their PBMs’ abuse of patients and pharmacies. “As one of the largest investors in United Healthcare, CVS, and Cigna, Vanguard is in a unique position to help effectuate real and meaningful change on beh
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May 25, 20232 min read


Health Insurance Claim Denied? See What Insurers Said Behind the Scenes
Learn how to request your health insurance claim file, which can include details about what your insurer is saying about you and your...
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May 16, 202310 min read


What is transparency? 6 things to look for in a PBM contract
Apparently, everyone is for transparency now. So why do employers and their brokers still struggle to understand prescription drug...
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Apr 12, 20236 min read


Move the Pharmacy Benefit Manager Transparency Act of 2022 forward
CT Mirror “I cannot afford to live.” – Patients are screaming at the outrageous prescription drug costs. The U.S. spends three times more...
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Apr 11, 20233 min read


National Poll Shows Overwhelming Support for Congressional Efforts to Hold PBMs Accountable
Bipartisan Respondents Strongly Favor Policies that Require PBMs to Provide Value and Lower Drug Costs PBM Accountability Project With...
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Mar 30, 20232 min read


Senate Commerce approves PBM transparency bill
Axios Pro The Senate Commerce Committee approved the bipartisan Pharmacy Benefit Manager Transparency Act Wednesday on an 18-9 vote. Why...
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Mar 22, 20232 min read


The List of PBM Formulary Exclusions Got Longer in 2023
Pharmacy benefit managers say they exclude high-cost drugs and have alternatives on their formularies. Critics say exclusions narrow...
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Mar 13, 20233 min read


FTC’s Enforcement Action Against GoodRx Breathes New Life into Decade Old Regulation
Lexology The Federal Trade Commission (FTC) didn’t mince words. On September 2021, it called out the health app industry for failing to...
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Mar 9, 20237 min read


Cigna hit with ERISA class action lawsuit for allegedly overcharging members
The health care provider negotiates lower rates with in-network providers to save members money, however, members allege that Cigna...
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Mar 7, 20232 min read


Patients Caught in Drug Industry, PBM Battle on Copay Assistance
CMS rule leaves high out-of-pocket costs, lawsuit argues Aid programs ‘mask’ problem of prices, analysts say Bloomberg Law High drug...
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Mar 6, 20235 min read


Aspirations 2023: What I Hope To See Happen In Healthcare And Public Health (But Probably Won’t)
Forbes Previously this month, I gave predictions for 2023. Here, I’ll offer some aspirations for the healthcare system in 2023: What I...
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Jan 12, 20236 min read


Everyday High Prices
How discounting led to inflation, shortages, and inequality. Washington Monthly Magazine Author: Phillip Longman For years, the only...
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Jan 10, 202310 min read


To Beat Overbilling Allegations, Cigna Says Everybody Does It
Law360 Cigna has told a Tennessee federal judge that the U.S. Department of Justice's False Claims Act lawsuit accusing it of defrauding...
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Dec 20, 20222 min read


The health insurer will see you now: How UnitedHealth is keeping more profits, as your doctor
STAT News By Bob Herman Next year, UnitedHealth Group — one of the largest health care companies on the planet — expects to make a lot...
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Dec 5, 20225 min read


World’s Top-Selling Drug Going Off Patent Means Big Bucks for Middlemen
As AbbVie’s Humira faces copycat biologics, the biggest beneficiaries will be the middlemen negotiating and dispensing the drugs such as...
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Nov 30, 20223 min read


Elon Musk, Bernie Sanders and Others Miss the Mark Over Pricey Insulin
Big Pharma has taken much of the heat for sky-high insulin prices, but scrutiny could soon shift to other companies grabbing a growing...
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Nov 29, 20223 min read


What do Ticketmaster and Pharmacy Benefit Managers have in common?
Pacific Research Institute Popular American singer and songwriter, Taylor Swift, released her newest album ‘Midnights’ in October. The...
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Nov 28, 20223 min read


How To Get Away With Corporate Murder: Unbundling And Disrupting Pharmacy Benefit Managers (Part 2)
This two-part article was researched and written in partnership with Cathy DuRei, President of Rumbly Health. Part 1 delved into what a...
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Nov 23, 20228 min read


How To Get Away With Corporate Murder: Unbundling And Disrupting Pharmacy Benefit Managers (Part 1)
Forbes If, as Mitt Romney said, a corporation is a person, then is it akin to murder if an idea takes down a company? What about if it...
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Nov 19, 20227 min read
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