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How To Get Away With Corporate Murder: Unbundling And Disrupting Pharmacy Benefit Managers (Part 2)
This two-part article was researched and written in partnership with Cathy DuRei, President of Rumbly Health. Part 1 delved into what a...

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8 min read


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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5 min read


DOJ to appeal UnitedHealth-Change Healthcare merger challenge
In its antitrust challenge to a UnitedHealth Group-Change Healthcare deal, the Department of Justice argued that the merger would allow...

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1 min read


How To Get Away With Corporate Murder: Unbundling And Disrupting Pharmacy Benefit Managers (Part 1)
Forbes If, as Mitt Romney said, a corporation is a person, then is it akin to murder if an idea takes down a company? What about if it...

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7 min read


Oklahoma proposes landmark rule to keep mailed medications safe from extreme temperatures
There is little regulation of how pharmacies ship drugs to patients, though extremes of hot or cold can make medicine unsafe or...

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3 min read


Federal Trade Commission to Expand Use of Law Against Anticompetitive Practices
Action could lead to more legal challenges against alleged unfair practices by businesses The Wall Street Journal The Federal Trade...

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3 min read


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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1 min read


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 read


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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2 min read


‘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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10 min read


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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3 min read


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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2 min read


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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3 min read


Nearly 15,000 Pharmacies Leaving Tricare Next Month
Military.com Thousands of independent and community pharmacies are poised to be dropped from Tricare's pharmacy network next month in a...

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2 min read


FTC's Bedoya Says Antitrust Cares Too Much About Efficiency
Law360 Federal Trade Commission member Alvaro M. Bedoya said Thursday that antitrust enforcement has been too concerned with how...

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3 min read


Angry at Big Pharma? Direct it at Big PBM!
LinkedIn Pulse Big Pharma has a very bad reputation, 58% disapprove, however people should REALLY be pissed at another small group of...

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5 min read


Most Americans Worry About Accessing Health Care, Poll Finds
Some 80% of Americans worry about how they will access good health care, according to a new Associated Press-NORC Center for Public...

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2 min read


CVS deal for Signify seen facing tough antitrust review
Reuters CVS Health Corp's (CVS.N) plan to buy healthcare services company Signify Health for about $8 billion will face a tough U.S....

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2 min read


Briefs sealed in UnitedHealth and Change antitrust trial
District Judge Carl Nichols is expected to release a ruling in the case before the end of October. Healthcare Finance Briefs in the case...

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2 min read


A Stethoscope for Spending: Transparency for PBMs
Real Clear Health At its invention, the stethoscope was revolutionary—the first non-lethal way of exploring a patient’s internal anatomy....

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2 min read
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