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PBM Issues


PBMs Implement Sweeping Reimbursement Cuts and Ramp Up Audits
Actions add a dour note to the new year Pharmacy Practice News Pharmacy benefit managers (PBMs) have responded to the new Centers for...
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Jan 16, 20245 min read


Have You Been Overcharged for Prescription Drugs? We Want to Hear From You.
The New York Times is looking into pharmacy benefit managers, which play crucial roles in determining which medications your insurance...
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Jan 15, 20241 min read


Press Release | PUTT Applauds AZ Governor Katie Hobbs For Taking On Prescription Drug Middlemen "Price Gouging"
FOR IMMEDIATE RELEASE January 9, 2024 Governor’s Plan Includes Ending Pharmacy Benefit Manager Practice of Overcharging for Prescriptions, Ensuring No One is Forced to Choose Between Life-saving Medicine and Rent WINSTON-SALEM, NC (January 9, 2024) – Pharmacists United for Truth and Transparency (PUTT) applauds Arizona Governor Katie Hobbs for her plan to bring soaring prescription drug prices under control by regulating how pharmacy benefit managers (PBMs) establish the pric
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Jan 9, 20242 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


Pharmacies fear New Year’s financial squeeze from Biden administration rule
STAT+ The Biden administration seemed to be giving pharmacies a win when they forced pharmacy benefit managers to be more up-front about...
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Jan 3, 20242 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


UnitedHealth, OptumRx sued by independent pharmacy over ‘unconscionable’ fees
Osterhaus Pharmacy in Iowa is also behind a similar suit against CVS Caremark. Healthcare Dive Dive Brief: UnitedHealth and its pharmacy...
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Dec 21, 20233 min read


Pharma has little visibility into the growing area of PBM fees
Lack of consistent insight into PBM service fees puts drugmakers at a disadvantage when calculating prices. MM+M | Medical Marketing &...
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Dec 13, 20234 min read


The looming pharmacy crisis in America | NPR's On Point
To listen to this news interview on NPR, click here Pharmacists at major chain stores like CVS and Walgreens are at a breaking point....
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Dec 9, 202318 min read


Reforming PBM Practices Would Improve The Pharmacy Market
Forbes Patients, the ultimate healthcare arbiter, continue to bear the costs from the perverse incentives driving the pharmacy benefit...
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Dec 7, 20234 min read


How Cigna saves millions by having its doctors reject claims without reading them
Oregon Live | Business When a stubborn pain in Nick van Terheyden’s bones would not subside, his doctor had a hunch what was wrong....
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Dec 1, 202310 min read


Biden's limit on drug industry middlemen backfires, pharmacists say
CBS News The Biden administration's first major step toward imposing limits on the pharmacy benefit managers who act as the drug...
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Nov 14, 20235 min read


Ohio pharmacy board members seem skeptical of CVS claims
Ohio Capital Journal A disciplinary hearing related to understaffing at some CVS pharmacies in Ohio didn’t come to a conclusion...
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Nov 10, 20234 min read


Study Highlights PBMs’ Role in Drug Prices
An analysis by 3 Axis Advisors has found that there is a large variability in pharmacy reimbursement of prescription drugs depending on...
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Nov 9, 20233 min read


How the secrecy of middlemen inflates drug prices
The Hill Most Americans believe drugs cost too much and big pharma is to blame. That powerful political sentiment undergirds Medicare’s...
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Oct 25, 20234 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


Hawaii Targets PBMs With Suit Alleging Unfair Pricing System
COURT: Haw. Dist. Ct. DOCKET: No. 1CCV-23-0001281 Bloomberg Law Hawaii has joined the legal fray against the country’s top companies...
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Oct 12, 20232 min read


CVS Caremark sued over back-end pharmacy fees
Axios Community pharmacies in a new lawsuit claim CVS Health and its Caremark pharmacy benefit manager violated antitrust laws and...
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Oct 7, 20232 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
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