Following a contentious summer between regulators and pharmacy benefit managers (PBMs), the Cigna subsidiary ExpressScripts has now sued the Federal Trade Commission (FTC) and demands it retract a July report that found the three largest PBMs place profits over patients.
The FTC report, which is the culmination of a federal probe into...
Last week, UnitedHealth Group's (UHG) health care technology subsidiary Change Healthcare was hit by a cyberattack that disrupted services for pharmacies and patients.
UHG said that once the attack was detected, Change was forced to disconnect some of its digital network from client access and shut down services including programs...
This week, the Health and Human Services Committees in the Arizona House and Senate heard a number of bills related to the administration of health and health policy and local industry advocates are speaking up to remind lawmakers of what's on the line this session.
As tensions around immigration issues rise nationally, Arizona Health...National News
While America waits for the outcome of debt ceiling negotiations between the U.S. House of Representatives leadership and President Joe Biden, the rest of Congress is underway addressing some of the criticisms of nursing home care and pharmacy benefit managers.
The Senate Special Committee on Aging posted a new report demonstrating...National News
Capitol Hill has turned its eye to pharmacy benefit managers (PBMs), culminating in a new package of measures introduced by leaders of the Senate Health, Education, Labor and Pensions (HELP) Committee that seeks to bring PBMs under more careful regulatory authority.
In February, the Federal Trade Commission (FTC) enforced the very...National News
This week, some of the insuretech companies that spent the past year struggling are trying to change their fortunes. Oscar Health brings on a seasoned, experienced CEO with a new goal and Bright Health is making some desperate stock moves.
Mark Bertolini, former CEO of Aetna and hedge fund Bridgewater Associates was appointed CEO of...White Papers, E books, Reports and more
The American Medical Association (AMA) published a study last month that found a lack of "competition in local markets" among pharmacy benefit managers (PBMs).
The analysis found that over a third of national markets for formulary management and benefit design were managed in-house by insurance companies rather than purchasing middle...National News
In addition to overturning Roe v. Wade and with it abortion access for millions of American women, the Supreme Court ended their term this year with a slew of other decisions that will carry new precedent for health industry legal cases going forward.
Last Friday, the high court announced an end to a years-long fight between the U.S....
The increasing burden of prior authorization, as well as the rise of “fail first” policies has become costly and harmful for patients – so much so that the American Medical Association (AMA) has engaged a law firm to pursue curtailing prior authorization.
According to the American Journal of Managed Care (AJMA), Barbara...
A myriad of fiscal and monetary stimulus has come out of Washington in recent months with the government and the Federal Reserve working jointly to provide financial aid and inject liquidity into industries struck by an unprecedented supply and demand shock. The government has provided $175 billion in relief funds to hospitals and other...Arizona News
Two studies highlight the role of health plans in driving up out-of-pocket prescription drug costs for 2019 individual Affordable Care Act (ACA) exchange enrollees, while insurers continue to file lawsuits against the federal government for unpaid cost-sharing reduction payments (CSRs).
Multiple insurers filed status reports in...Arizona News
A Boston federal judge ruled in favor of the Amazon, Berkshire Hathaway, and J.P. Morgan healthcare venture on Friday, Feb. 22; in dispute was UnitedHealth’s request for former Optum executive David Smith to stop talking trade secrets he acquired during his time at United. Details on the healthcare conglomerate were also finally...Arizona News
Last week the Department of Justice gave CVS and Aetna approval for their $69 billion merger on the condition that Aetna sells off its Medicare Part D prescription drug business. Insurers cozying up with the pharmaceutical industry is a growing trend, think: OptumRx and UnitedHealth, or the recent Cigna-Express Scripts...National News
Prescription drug rebates are typically negotiated by pharmacy benefits managers (PBM), such as CVS and United (two of the largest PBMs), but Department of Health and Human Services (HHS) Secretary Alex Azar says he has the power to eliminate them in the United States.
Pharmaceutical companies on Thursday, Aug. 10 were notified...National News
Insurers buy pharmacy providers, hospitals may be the next target.
The continued market consolidation and efforts to create an “all-in-one” approach to healthcare insurance customers may lead to carriers acquiring large hospital networks, particularly if the CVS-Aetna transaction proves to be successful and profitable, one analyst...National News
Prescription drug spending is a billion dollar expense for insurers and self-insured employers.
Allying with a pharmacy benefit manager may be tempting when looking at discounts, annual drug savings, promotion of generic drugs and cheaper prescription alternatives. They can also help payers facilitate enhanced care delivery....National News
Payer-pharmaceutical alliances may be powerful if the right partners are involved.
The CVS-Aetna deal creates the first health-care triple threat, combining CVS' pharmacy and pharmacy benefits manager platform with Aetna's insurance business. The threat to pharmacies-or those that own them-is the way in which the two will leverage...