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Pharmacy Benefits Manager

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

Recovery Audit Contracting: The Wave of the Future

June 8, 2013 staff

On the large list of sources of waste in Medicare, improper payments are near the top.  According to a February 27, 2013 Government Accountability Office (GAO) report, “In 2012, the Medicare program covered more than 49 million elderly and disabled beneficiaries at an estimated cost of $555 billion, and reported improper payments estimated to be more than $44 billion.”  Medicare’s high level of complexity and susceptibility to improper payments are among the reasons that the GAO designates Medicare as a high-risk area.  One method that has proven successful in reducing improper payments is the increased usage of recovery audit contractors (RACs).

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

Peeling Back Another Onion

May 22, 2013 staff

As I wrote last week, HHS Secretary Kathleen Sebelius has gotten herself into some hot water concerning her solicitation for donations for non-profit groups that will help with the implementation of Obamacare.  She asked for donations from corporations, some of which are regulated by HHS, and foundations. Reuters reports the non-profit “Enroll America” seems to […]

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

Show Me the Money

May 17, 2013 staff

The Washington Post had an interesting column a few days ago.  It seems Health and Human Services (HHS) Secretary Kathleen Sebelius is asking for more money from health industry officials to help implement Obamacare since Congress is refusing to provide more funds.  While the effort is caged as asking for “donations” it does not take […]

Budget, Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Durable Medical Equipment: Free Market Principles Will Deliver Best Options for Taxpayers

May 3, 2013 Thomas Schatz

In 2003, Congress passed the Medicare Modernization Act (MMA – P.L. 108-173). This law made some substantial changes to Medicare and adding competitive forces to the program was a strong theme.

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Never Mind

April 27, 2013 staff

Yesterday, I blogged about a story in the newspaper Politico that said members of Congress were looking for ways to exempt themselves and their staff from Obamacare.

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

What’s Good for the Goose is Good for the Gander – NOT!

April 26, 2013 staff

All you need to do to find out how “wonderful” the Affordable Care Act or Obamacare will be for all of us is to go to the White House Web site.  In almost reverent slogans the Obama Administration claims.

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Train Wreck

April 24, 2013 staff

Today, Senator Max Baucus (D-MT) announced his retirement – joining five other Democrat senators calling it quits.

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

Entitlements – Welfare and Unemployment

April 6, 2013 staff

Entitlements – Welfare and Unemployment The United States has a significant, current and growing problem with entitlement spending, particularly the federal portion.

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

The Flights of the Navigators

April 5, 2013 staff

You might think I am going to talk about the 1886 movie, “The Flight of the Navigator,” but in this case, you would be wrong.

Healthcare, PBM, PBMs, Pharmacy Benefits Manager, Technology, Telecommunications

Testing the Waters on Health Technology

April 3, 2013 Deborah Collier

While the number of physicians who use computers to store patient information is rising, most are still clinging to large manila file folders to record and retain complete patient histories.  U.S. News and World Report reported on February 20, 2013 that, in spite of incentives from the U.S. government, a study conducted by Adam Write, a senior research scientist at Brigham and Women’s Hospital and an Assistant Professor of Medicine at Harvard Medical School in Boston, found that doctors are slow to adopt electronic health records (EHRs), with only 1 in 6 using the new technology. 

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