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Medicare/Medicaid
DOJ sues Cigna alleging Medicare Advantage fraud
Modern Healthcare The Justice Department has sued Cigna for allegedly collecting tens of millions of dollars in excess Medicare payments...
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Oct 17, 20222 min read
‘The Cash Monster Was Insatiable’: How Insurers Exploited Medicare for Billions
By next year, half of Medicare beneficiaries will have a private Medicare Advantage plan. Most large insurers in the program have been...
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Oct 12, 202210 min read
Nearly 20% of Medicare Advantage plans lose star revenue for 2023
Modern Healthcare Just half of Medicare Advantage plans with prescription drug coverage received ratings that will earn them bonuses for...
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Oct 7, 20223 min read
Anthem must face Medicare Advantage fraud lawsuit, judge rules
Modern Healthcare Author: Nona Tepper Anthem must face a Justice Department lawsuit alleging the Medicare Advantage insurer intentionally...
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Oct 5, 20222 min read
Health insurers are painting a misleading picture of Medicare Advantage savings, experts say
STAT News The health insurance industry is continuing its campaign to convince the public that Medicare Advantage saves taxpayers money,...
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Sep 30, 20223 min read
Seeking to Kick-Start Biden’s Agenda, Schumer Unveils a Bill for Medicare Drug Price Negotiations
Kaiser Health News Democratic senators on Wednesday took a formal step toward reviving President Joe Biden’s economic agenda, starting...
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Jul 11, 20224 min read
8 in 10 registered voters support requiring insurance & PBMs to share rebates directly with patients
A new PhRMA/Ipsos poll finds that there is wide support for policies that require health insurers and their pharmacy benefit managers...
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Jun 27, 20222 min read
Lawmakers ask GAO to probe pharmacy benefit managers over their role in drug pricing
STAT News Amid intensifying scrutiny of pharmacy benefit managers, a group of House Republicans is urging the U.S. Government...
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Jun 19, 20224 min read
Beat cancer? Your Medicare Advantage plan might still be billing for it
Firms mined patient records for outdated, irrelevant conditions to increase profits, Justice Department contends The Washington Post...
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Jun 14, 202211 min read
Ohio Medicaid accused of strong-arm tactics on pharmacies, just like PBMs
The Columbus Dispatch Pharmacy deserts for the poorest and disabled Ohioans could grow unless a dispute over new state Medicaid contracts...
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May 31, 20224 min read
AHA presses for False Claims Act probes to target payers over Medicare Advantage denials
The Justice Department needs to create a task force to study potential False Claims Act violations conducted by Medicare Advantage plans,...
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May 25, 20222 min read
Improve the Pharmaceutical Ecosystem for Patients
Health care policy decisions based on sound data and research are essential for addressing the challenges. Pharmacy Times Pharmacists are...
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May 17, 20224 min read
Biden plan to slash pharmacy fees, cut seniors' out-of-pocket costs delayed until 2024
The Columbus Dispatch Millions of U.S. seniors were supposed to get price relief soon on their prescription drugs under a revamp of...
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May 1, 20224 min read
Vertically integrated payer-provider groups raise antitrust concerns
Modern Healthcare More commercial insurers are overhauling their business models in response to changes ushered in by the Affordable Care...
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Mar 30, 20229 min read
Yost opens investigation into PBM maneuver
Insurance NewsNet Ohio Attorney General Dave Yost has launched an investigation into an obscure drug-pricing maneuver that could be both...
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Mar 18, 20223 min read
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