by Bruce Japsen
Published in Forbes, 2/1/18
The top insurance official in California urged the U.S. Justice Department to block the merger of CVS Health and Aetna, saying it would “have significant anti-competitive impacts on American consumers and health care and health insurance markets.”
The findings and recommendation by California Insurance Commissioner Dave Jones doesn’t derail the effort by CVS Health to buy Aetna, but the state regulator could have influence with the U.S. Justice Department as it evaluates the deal. California's insurance regulator described the Justice Department evaluation of the Aetna-CVS deal as "open" and outlined its reasoning for DOJ to block it in a 15-page letter.
Pharmacy First, a national network of more than 2,300 independent pharmacies, filed a lawsuit against Express Scripts in Federal Court to seek relief for, among other things, Express Scripts effectively excluding from its network of 83 million or more lives from Pharmacy First and all other Pharmacy Services Administration Organizations (“PSAOs”), except for four PSAOs handpicked by Express Scripts.
Kentucky, lawmakers discovered that PBMs, including CVS, pocket over 40% of the state’s annual Medicaid spending on prescription drugs.
It happened in Ohio, Arkansas, Iowa, New Jersey, New York and possibly other states. Pharmacy middleman CVS Caremark suddenly cut the reimbursements it paid community pharmacies for drugs, some of them far below pharmacists’ costs for potentially lifesaving medications.