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Strange bedfellows agree: PBM pricing reform cannot stop at Medicare, Medicaid
HEALTH CARE un-covered by Wendell Potter Regular readers of this newsletter know that pharmacy benefit managers have come to be an...

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3 min read


Local pharmacy owner, patient share concerns over relationships between PBMs and insurance companies
Fox News 2 For nearly 30 years, Betty Whitcomb’s trusted this independently owned pharmacy in Overland for her pills. “He just lets me...

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2 min read


How PBM legislation would transform the industry
Modern Healthcare The pharmacy benefit manager industry could look a lot different soon if Congress follows through with bipartisan...

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4 min read


Feds drop appeal in drug copay assistance case
Modern Healthcare The federal government has dropped its appeal of a court decision that could affect health insurance companies' use of...

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2 min read


Delaware committee advises against Medicare Advantage for state retirees
Becker's Payer Issues A state committee is recommending Delaware cast aside any plans to provide retired state employees health benefits...

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1 min read


1 big thing: Employers in the dark
Axios Vitals Employers are facing stronger legal requirements to ensure they aren't wasting their workers' money on overpriced health...

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2 min read


Small Business Needs PBM Reform Now
RealClear Health Small businesses -- your favorite local coffee shop, boutique, salon and florist -- punch way above their weight in the...

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3 min read


Express Scripts sued for allegedly colluding with rival PBMs to fix prices
MobiHealthNews An antitrust lawsuit has been filed against Cigna-owned online pharmacy and pharmacy benefit manager (PBM) Express Scripts...

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1 min read


PBMs Implement Sweeping Reimbursement Cuts and Ramp Up Audits
Actions add a dour note to the new year Pharmacy Practice News Pharmacy benefit managers (PBMs) have responded to the new Centers for...

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5 min read


Have You Been Overcharged for Prescription Drugs? We Want to Hear From You.
The New York Times is looking into pharmacy benefit managers, which play crucial roles in determining which medications your insurance...

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1 min read


Tenth Circuit Decision on Regulating Pharmacy Benefit Managers Remains in Place As Oklahoma Appeals to U.S. Supreme Court
Duane Morris Law A decision from the United States Court of Appeals for the Tenth Circuit, which found that several provisions of an...

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3 min read


NACDS unveils new spot on PBM reform
Chain Drug Review A new television ad from NACDS urges Congress to enact bipartisan pharmacy benefit manager (PBM) reforms that it has...

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2 min read


California fines Anthem Blue Cross for slow provider payments
Becker's Payer Issues The California Department of Managed Health fined Anthem Blue Cross of California $690,000 for failure to reimburse...

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1 min read


Nearly half of every dollar spent by Medicare drug plans goes to private health insurers' pharmacy benefit managers and wholesalers
Healthcare UN-Covered by Wendell Potter As members of Congress get back to business after the holidays, they seem to be poised to pass...

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4 min read


Pharmacies fear New Year’s financial squeeze from Biden administration rule
STAT+ The Biden administration seemed to be giving pharmacies a win when they forced pharmacy benefit managers to be more up-front about...

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2 min read


NYC Transit Retirees WIN Important Battle Against Medicare Advantage Push
TWU Local 100 retirees fighting to retain their traditional Medicare Benefits were dismissed back in October — this week, they won a...

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6 min read


UnitedHealth, OptumRx sued by independent pharmacy over ‘unconscionable’ fees
Osterhaus Pharmacy in Iowa is also behind a similar suit against CVS Caremark. Healthcare Dive Dive Brief: UnitedHealth and its pharmacy...

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3 min read


The House passed its health bill. How's the Senate doing?
Axios Pro The House's passage of its big health care transparency bill this week shifts the focus to the Senate, which will have to work...

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2 min read


Pharma has little visibility into the growing area of PBM fees
Lack of consistent insight into PBM service fees puts drugmakers at a disadvantage when calculating prices. MM+M | Medical Marketing &...

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4 min read


House passes site-neutral policy, transparency, PBM reform package
STAT News The House passed a relatively major health care package late Monday, an end-of-year victory after the same policies had to be...

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2 min read
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