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‘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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10 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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3 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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2 min read
FTC's Bedoya Says Antitrust Cares Too Much About Efficiency
Law360 Federal Trade Commission member Alvaro M. Bedoya said Thursday that antitrust enforcement has been too concerned with how...
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3 min read
FTC Caught in Balancing Act With Pharmacy Benefit Manager Probe
PBM group says independent pharmacies are ‘stable’ ‘Need to understand’ what’s happening with drug supply chain, consumer costs Bloomberg...
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4 min read
FTC Goes After PBMs, Warns Of Legal Action
Forbes Last month, the Federal Trade Commission (FTC) voted unanimously (5-0) to examine rising list prices of insulin, but also to probe...
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3 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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4 min read
FTC Probe Into Rx Middlemen May Spark Industry Shakeup
Law360 Concerns that pharmaceutical middlemen inflate drug prices and harm patients have led the Federal Trade Commission to launch a...
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7 min read
Federal Trade Commission And Congress Want To Rein In PBMs
Forbes Both the Federal Trade Commission (FTC) and Congress want to rein in pharmacy benefit managers (PBMs), as they focus on alleged...
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3 min read
Industry middlemen driving up prices of generic drug prescriptions as much as 20 percent: research
The Hill U.S. consumers are overpaying billions for generic drugs due to the cost being driven up by middlemen in the pharmaceutical...
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2 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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2 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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4 min read
Louisiana sues health care company over practices under investigation in Ohio
Legal document says UnitedHealth inflated drugs by “billions” Ohio Capital Journal Louisiana is suing health care giant UnitedHealth over...
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3 min read
Prospect of lower fees for prescription drugs could be dashed by new maneuver from PBMs
The Columbus Dispatch A few months ago, proposed federal action to reduce fees on prescription drugs used by millions of older Americans...
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6 min read
Bipartisan pressure may prompt Federal Trade Commission to investigate drug middlemen
The Columbus Dispatch For consumer advocates who contend that only the federal government has a hammer big enough to rein in...
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5 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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3 min read
More than $300 Billion in Health Care Spending Goes to Middlemen. We Need Accountability.
Real Clear Policy Too many people go to the pharmacy counter only to be told the cost of their prescription medicine has gone up. Again....
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2 min read
Pharmacy Agent Study Would Show Role in Drug Price ‘Dysfunction’
Rebates should get focus in PBM probe, policy watchers say Proprietary data protections can complicate transparency Bloomberg Law The...
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4 min read
To Be, Or Not To Be... A Fiduciary
Faced with what appears to be an endless increase in prescription drug costs, employers need a clear view into the prices they pay for...
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5 min read
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