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PBMs

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Eligibility Check Reveals Massive Medicaid Problems in Oregon

September 20, 2017 Spencer Chretien

Oregon attracted national ridicule in 2013 and 2014 as its state-run online Obamacare exchange, Cover Oregon, epically failed to sign up even one person for coverage, despite a federal grant of $303 million.  The fiasco was so colossal that the state gave up completely and had the federal government take over its enrollment for the […]

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Two Significant Healthcare Bills Introduced to Replace Obamacare

September 14, 2017 Elizabeth Wright

On Wednesday, two important healthcare bills were introduced in the Senate to replace the Patient Protection and Affordable Care Act (ACA), or Obamacare.  One bill, introduced by Sens. Bill Cassidy (R-La.), Lindsey Graham (R-S.C.), Dean Heller (R-Nev.), and Ron Johnson (R-Wisc.), would amend the healthcare reform legislation that passed the House in May, the American […]

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

No, Obamacare’s Problems Are Not Over

August 30, 2017 Elizabeth Wright

Last Wednesday, August 23, 2017, the Centers for Medicare and Medicaid Services (CMS) announced that only one county, Paulding County, Ohio, would have no health insurers participating in the Patient Protection and Affordable Care Act (ACA), or Obamacare.  Admittingly, this was a very different scenario from what was anticipated just a few months ago.  In June, the New York […]

The Can-Kicking Congress: Business as Usual
Appropriations, Budget, General Waste, Healthcare, PBM, PBMs, Pharmacy Benefits Manager, Taxes, Transportation

The Can-Kicking Congress: Business as Usual

August 28, 2017 wchristian

In political patois, “kicking the can down the road” connotes procrastination.  As long as the proverbial can is kicked “down the road,” rather than picked up, then the proper disposition of the derelict container is put off until some future point in time.  And much like the (equally proverbial) kicker’s aversion to taking definitive action on a relatively straightforward task, the U.S. Congress is composed of 535 “can kickers,” given their predilection to avoid taking action until the last possible minute.  On Tuesday, September 5, 2017, when the current Congress reconvenes after its annual August recess, it will have less than a month to complete several “must pass” items.

The Summer of Healthcare Discontent
Healthcare, PBM, PBMs, Pharmacy Benefits Manager

The Summer of Healthcare Discontent

August 28, 2017 Elizabeth Wright

As the end of their summer recess approaches, the Republican-controlled Congress has still not done what it has promised to do since March 2010:  repeal the Patient Protection and Affordable Care Act (ACA), or Obamacare, and allow consumer-driven forces to create more competition and choices in order to drive down healthcare costs.  It has been said that Republicans behaved like a dog which had constantly chased after a car and then finally caught it:  They were ill-prepared about what to do after Obamacare was snagged in their metaphorical jaws.

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Congress Reacts to Largest Federal Healthcare Fraud Enforcement Action

July 27, 2017 staff

On Thursday, July 13, 2017, the Department of Justice (DoJ) announced in a press release the largest healthcare fraud enforcement action in its history.  Attorney General Jeff Sessions and Department of Health and Human Services (HHS) Secretary Tom Price, M.D., announced the takedown, in which over 412 individuals were found responsible for $1.3 billion in fraud losses. 

The Dangers of Single-Payer Healthcare
Healthcare, PBM, PBMs, Pharmacy Benefits Manager

The Dangers of Single-Payer Healthcare

July 26, 2017 staff

CAGW’s June 2017 Porker of the Month was Sen. Bernie Sanders (I-Vt.), who earned the “honor” in part due to his outspoken and unwavering support of the single-payer healthcare system.  Sen. Sanders touts the system as the “morally principled” option; in reality, it would create long waiting times, cause a massive increase in taxes, and allow bureaucrats in Washington to make decisions that ought to be made between doctors and patients.  

Vacant VA Buildings Cost Taxpayers Millions
Defense, Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Vacant VA Buildings Cost Taxpayers Millions

July 26, 2017 Curtis Kalin

The Department of Veterans Affairs (VA) has gone through many trials and travails over the past several years.  A new report from the Government Accountability Office (GAO) exposed another aspect of the department that enables waste and mismanagement.

The FDA Should Pave the Way to Tobacco Harm Reduction
Healthcare, PBM, PBMs, Pharmacy Benefits Manager

The FDA Should Pave the Way to Tobacco Harm Reduction

July 26, 2017 Elizabeth Wright

Passage of the Family Smoking Prevention and Tobacco Control Act (TCA) in June 2009 gave the Food and Drug Administration (FDA) regulatory control over tobacco products.  The purpose of the TCA, as stated in the bill’s report language, was to permit the FDA “to restrict the sale and distribution of tobacco products, including advertising and promotion” and to “take specified actions, including public notification and recall, against unreasonably harmful products.”  The law also required the FDA “to establish tobacco product standards to protect the public health” but prohibited the agency from “banning all cigarettes, all smokeless tobacco products, all little cigars, all cigars other than little cigars, all pipe tobacco, or all roll-your-own tobacco products,” or “requiring the reduction of nicotine yields of a tobacco product to zero.”  Notably, the law also set forth standards for the sale of “modified-risk tobacco products.”

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Wasteful Spending by Hospitals Increased Under Obamacare

July 24, 2017 Elizabeth Wright

In 1998, Citizens Against Government Waste released “Are You Getting Your Money’s Worth from Nonprofit Hospitals?” which analyzed the level of charity care nonprofit hospitals were providing to their local communities as a requirement under their tax exemptions.  The report found that for-profit and nonprofit hospitals are not much different in terms of the charity they provide to their respective communities.  The only difference is that taxpayers are subsidizing the nonprofits.

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