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Medicare/Medicaid
Bipartisan Senate plan would regulate PBM compensation, target ‘unfair’ drug price hikes
Healio Key takeaways: The bipartisan plan would decouple pharmacy benefit manager compensation from drug prices, among other reforms. The...
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Apr 25, 20232 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
Denied by AI: How Medicare Advantage plans use algorithms to cut off care for seniors in need
STAT+ News An algorithm, not a doctor, predicted a rapid recovery for Frances Walter, an 85-year-old Wisconsin woman with a shattered...
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Mar 16, 20239 min read
The lunacy of 340B and Medicare’s inability to negotiate drug prices
Why do we mandate a better deal for business than for taxpayers? Health Care un-covered by Wendell Potter When you combine Medicare’s...
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Feb 22, 20235 min read
Biden’s SOTU Targets Drug Companies, But Misses Opportunity To Challenge Health Insurers And PBMs
Forbes President Biden’s State of the Union Address hammered home the point that drug prices must come down. He reminded viewers that he...
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Feb 17, 20235 min read
‘We Ain’t Gonna Get It’: Why Bernie Sanders Says His ‘Medicare for All’ Dream Must Wait
KHN After railing at the injustices of U.S. health care for decades, Sen. Bernie Sanders in January became the new chairman of the Senate...
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Feb 16, 20236 min read
Senators introduced bills to reform PBMs and create new FTC probe
Fierce Healthcare Two top senators have reintroduced legislation that would introduce several reforms to pharmacy benefit managers,...
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Feb 1, 20233 min read
The Government Thinks It Is Overpaying for Medicare, Spelling Trouble for Insurers
Health insurers had a stellar 2022, but this year looks more challenging The Wall Street Journal Health insurers had the best of both...
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Jan 30, 20233 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
Drug Pricing Oversight to Get Prime Focus Under New Congress
Repeal of Biden’s drug pricing law unlikely, analysts say Pharmacy middlemen, insulin costs among top priorities Bloomberg Law Overseeing...
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Jan 5, 20235 min read
Through reverse auctions, Minnesota pushes for PBM savings and price transparency
By Christopher Snowbeck - Star Tribune Two large public sector health plans in Minnesota say they jointly will save more than $28 million...
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Jan 4, 20235 min read
Progressive lawmakers call on CMS to cull companies with history of Medicare fraud from ACO REACH
At least 10 organizations with records of healthcare fraud and abuse participated in the direct contracting program last year despite CMS...
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Dec 27, 20223 min read
How Medicare Advantage plans dodged auditors and overcharged taxpayers by millions
NPR In April 2016, government auditors asked a Blue Cross Medicare Advantage health plan in Minnesota to turn over medical records of...
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Dec 22, 20225 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
Hidden audits reveal millions in overcharges by Medicare Advantage plans
NPR Shots: Health News Newly released federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage...
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Nov 22, 20225 min read
Express Scripts to pay $3.2 mln to settle Massachusetts overcharge claims
Cigna unit accused of ignoring federal, state drug pricing benchmarks for workers' compensation beneficiaries Massachusetts previously...
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Nov 9, 20221 min read
How the 10 largest PBMs hold huge sway in health care marketplace
American Medical Association What’s the news: The AMA has gathered first-of-its-kind data on pharmacy benefit managers (PBMs) and its...
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Oct 25, 20222 min read
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