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PBMs

General Waste, Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Medicare Continues Fiscal Slide: Congress Sidelines Watchdogs

June 23, 2016 Leslie Paige

The 2016 Annual Report of the Board of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds Report came out today.  Bottom line:  the Trust Fund faces insolvency in 2028, two years earlier than was projected in last year’s report. But Centers for Medicare and Medicaid (CMS) Services Acting Administrator Andy […]

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Healthcare in the Spotlight in the House of Representatives

June 22, 2016 Rachel Cole

This week, the U.S. House of Representatives is considering two bills that would alleviate the strain Obamacare has placed squarely on the shoulders of businesses and taxpayers. The House considered H.R. 5447, the Small Business Healthcare Relief Act.  This legislation, introduced by Rep. Charles Boustany (R-La.), accomplishes two major goals:  allow small businesses to give […]

340B, Healthcare, PBM, PBMs, Pharmacy Benefits Manager

How the 340B Drug Discount Program is Increasing Cancer Costs

June 16, 2016 Elizabeth Wright

Cancer care costs are rising, and the 340B outpatient drug discount program is needlessly contributing to the increase.

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

CAGW Outraged by HHS OIG’s Latest Improper Payment Review

May 14, 2016 Curtis Kalin

Citizens Against Government Waste (CAGW) was outraged, if not surprised, at the report from the Department of Health and Human Services (HHS) Office of Inspector General (OIG) showing the ongoing failure of HHS executives to accurately report and prevent improper payments.  With the government-wide improper payment total at a staggering $137 billion in fiscal year (FY) 2015 (and rising), the OIG outlines some of the steps that agency has taken to stem the tide of red ink, but finds significant operational failures, in both its reporting of improper payments and implementing corrective action plans. 

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

State Tobacco Settlement Funds Go Up In Smoke

May 13, 2016 Andrew Nehring

In 1998, 46 states and five U.S. territories signed onto the Master Settlement Agreement (MSA) in order to recover taxpayer dollars lost to the treatment of tobacco-related health issues, which would then be used to fund anti-smoking campaigns and public health programs.  As part of the settlement, the states and territories will receive an estimated total of $246 billion over the first 25 years.

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

A New Cause du Jour: Beating Up “Big Pharma”

May 13, 2016 Elizabeth Wright

Beating up pharmaceutical companies is the new “cause du jour.”  Even though pharmaceuticals are only 10 percent of all healthcare costs, they tend to make easy targets because it is difficult to understand why such a small pill should cost so much money.

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Got Some Splainin To Do

May 12, 2016 Elizabeth Wright

Yesterday, May 10, 2016, the House and Energy Commerce Committee released a report, which demonstrates the Centers for Medicare and Medicaid Services (CMS) Acting Administrator Andrew Slavitt provided false testimony in a House Energy and Commerce Subcommittee on Oversight and Investigations hearing, “An Overdue Checkup Part II: Examining the ACA’s [Affordable Care Act] State Insurance Marketplaces.”  The hearing was held December 8, 2015.

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

UnitedHealthcare Cries Uncle

April 21, 2016 Elizabeth Wright

On Tuesday, April 19, UnitedHealthcare CEO Stephen Hemsley announced that the company would be pulling out of most of the Affordable Care Act’s (ACA), or Obamacare, marketplace exchanges.  This announcement did not come as a surprise.  On November 19, 2015, The Hill reported, “At a shareholder meeting Thursday, UnitedHealthcare cast doubt on its ability to carry plans on the healthcare law’s exchanges beyond 2016, offering a more grim financial outlook than it had previously expected.  ‘In recent weeks, growth expectations for individual exchange participation have tempered industrywide,’ said Stephen Hemsley, the company’s CEO.  ‘Co-operatives have failed, and market data has signaled higher risks and more difficulties while our own claims experience has deteriorated, so we are taking this proactive step.’”

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Lawyering Up Over Labels

April 20, 2016 Elizabeth Wright

On November 13, 2013, the Food and Drug Administration (FDA) released a proposed rule that would allow generic pharmaceutical firms to provide new safety information and update a drug’s label without first getting FDA approval, even though doing so would make it different from the reference drug’s (the original brand-name) label.  If the proposed rule should go in effect, it is conceivable that several versions of labels for the same medication could exist, creating uncertainty for physicians, pharmacists, and patients.

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Congress’s “Gift” to Obamacare

March 24, 2016 Elizabeth Wright

Yesterday was the Affordable Care Act’s (ACA) sixth anniversary. Better known as Obamacare, the law’s popularity since inception has never been above 50 percent according to RealClear Politics’ (RCP) polling data.

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