‘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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3 min
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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3 min
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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6 min
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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10 min
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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5 min
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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4 min
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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3 min
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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5 min
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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2 min
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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5 min
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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1 min
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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2 min
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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2 min
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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10 min
‘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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3 min
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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2 min
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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3 min
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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4 min
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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2 min
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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