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Medicare/Medicaid
Delaware committee advises against Medicare Advantage for state retirees
Becker's Payer Issues A state committee is recommending Delaware cast aside any plans to provide retired state employees health benefits...
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Jan 24, 20241 min read
California fines Anthem Blue Cross for slow provider payments
Becker's Payer Issues The California Department of Managed Health fined Anthem Blue Cross of California $690,000 for failure to reimburse...
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Jan 8, 20241 min read
Nearly half of every dollar spent by Medicare drug plans goes to private health insurers' pharmacy benefit managers and wholesalers
Healthcare UN-Covered by Wendell Potter As members of Congress get back to business after the holidays, they seem to be poised to pass...
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Jan 5, 20244 min read
NYC Transit Retirees WIN Important Battle Against Medicare Advantage Push
TWU Local 100 retirees fighting to retain their traditional Medicare Benefits were dismissed back in October — this week, they won a...
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Dec 26, 20236 min read
The House passed its health bill. How's the Senate doing?
Axios Pro The House's passage of its big health care transparency bill this week shifts the focus to the Senate, which will have to work...
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Dec 14, 20232 min read
House passes site-neutral policy, transparency, PBM reform package
STAT News The House passed a relatively major health care package late Monday, an end-of-year victory after the same policies had to be...
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Dec 12, 20232 min read
E&C approves PBM, Medicare coverage bills
Axios Pro The House Energy and Commerce Committee teed up a series of health bills for floor votes during a marathon markup on Wednesday...
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Dec 11, 20232 min read
Sen. Warren finally wises up to the 'unintended consequences' of a key Obamacare rule
Blaze Media Sen. Elizabeth Warren (D-Mass.) is finally acknowledging some of the "unintended consequences" of Obamacare, according to the...
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Nov 27, 20232 min read
Senate Finance Committee targets PBM reform in new legislation
The bill (which passed unanimously) would introduce more transparency and regulation to PBMs, and pharmacies would be required to report...
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Nov 16, 20233 min read
Hospitals are dropping Medicare Advantage left and right
Beckers Hospital Review Reporter: Jakob Emerson Medicare Advantage provides health coverage to more than half of the nation's seniors,...
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Oct 21, 20234 min read
Letters scare local Medicare patients
WAND News Two local pharmacies have been fielding dozens of phone calls after a pharmacy benefit manager, Express Scripts, sent out...
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Oct 6, 20232 min read
Drug Prices Are Too Damn High
It's been a long road to Medicare price negotiation ... and there's still work to be done MedPage Today Remember the "Rent is Too Damn...
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Sep 7, 20235 min read
California court resurrects Aetna retaliation lawsuit
The California Medical Association's lawsuit alleges Aetna had fired or threatened to fire doctors who referred patients to...
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Aug 10, 20232 min read
Congress Making Progress on Bills to Regulate PBMs
All measures would require more transparency about the fees they collect MedPage Today Confused by all the bills being introduced in...
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Aug 8, 20235 min read
How UHC’s acquisition of a popular Medicare Adv. algorithm sparked internal dissent over denied care
STAT News Reporters: Casey Ross and Bob Herman Frustration was boiling into open conflict within NaviHealth, a company that uses computer...
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Jul 14, 202312 min read
State Insurance Commissioners Seek Meeting With FTC On PBMs
Inside Health Policy The group representing state insurance commissioners is seeking information from the Justice Department and Federal...
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Jun 8, 20233 min read
Denials of health-insurance claims are rising — and getting weirder
Washington Post Opinion Author: Elisabeth Rosenthal Millions of Americans in the past few years have run into this experience: filing a...
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May 24, 20234 min read
Prescription-drug costs in spotlight as pharmacy benefit reform advances in Senate
Drugmakers, prescription-drug middlemen trade jabs over high cost of medications MarketWatch A bipartisan effort to rein in prescription...
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May 11, 20233 min read
Will Senate Hearing Expose PBMs’ Unscrupulous Drug Pricing Tactics?
Forbes Today , Sen. Bernie Sanders, I-Vt., will haul executives from three insulin manufacturers and three pharmacy benefit managers...
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May 11, 20233 min read
Another powerful congressional committee is ready to take on PBMs
STAT+ House Oversight Committee Chairman James Comer plans to hold a hearing on the results of an investigation into the business...
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May 3, 20233 min read
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