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I may be wrong, but this sounds like the “old HMO PIG” with a color of lipstick… that was tried back in the 1970’s and most of them failed because the organization became focused on cutting costs and rationing care to pts. The only people happy with this system was those that had little need […]
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Is the GRIM REAPER STALKING THE PBM INDUSTRY ? FTC to Ramp Up Enforcement Against Any Illegal Rebate Schemes, Bribes to Prescription Drug Middleman That Block Cheaper Drugs Agency puts drug industry on notice that paying rebates and fees to exclude competitors offering lower-cost drug alternatives can violate competition and consumer protection laws https://www.ftc.gov/news-events/news/press-releases/2022/06/ftc-ramp-up-enforcement-against-illegal-rebate-schemes The […]
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Whistleblower suit: CVS prevented Part D members from accessing generics https://www.fiercehealthcare.com/payers/whistleblower-suit-cvs-prevented-part-d-members-accessing-generics A newly unsealed whistleblower suit claims that multiple CVS Health subsidiaries coordinated to prevent members from accessing generic drugs in a bid to boost the bottom line. The suit, first obtained by Stat, was filed by Alexandra Miller, who worked at CVS for nearly two decades […]
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PBMs could be driving up plan sponsors’ drug costs https://www.benefitspro.com/2022/06/15/pbms-could-be-driving-up-plan-sponsors-drug-costs/ Far too many pharmacy benefit managers (PBMs) thrive on opacity in their business operations, but sometimes public litigation shines the light of day on secretive practices. Far too many pharmacy benefit managers (PBMs) thrive on opacity in their business operations, but sometimes public litigation shines […]
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I’m going “out on the third rail again”… I have noticed our President telling the “rich” should pay their fair share – and the “rich” is undefined. Current target of his “bully pulpit ” is the oil industry – for making excessive profits – and WH press secretary stated in the last day or two… […]
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Centene Corp. reaches $13.7M settlement with New Mexico over pharmacy benefit practices https://www.bizjournals.com/stlouis/news/2022/06/14/centene-million-settlement-new-mexico-pharmacy.html New Mexico is the latest state where Centene Corp. (NYSE: CNC) has reached a settlement over an investigation into its pharmacy benefit management practices for the Medicaid program. Attorney General Hector Balderas on Monday announced a $13.7 million settlement with Centene over […]
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The Government Needs to Get a Warrant if It Wants Access to Our Private Health Information Signing Of Arizona SB1469 on Controlled Substances Monitoring Search Warrants, into Law by Governor Douglas Ducey The Drug Enforcement Administration is once again trying to access private prescription records of patients — this time in New Hampshire — without a warrant, […]
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Harms of Cancer Blood Tests? FTC Healthcare Crackdown: More Smoke Than Fire? https://www.medpagetoday.com/special-reports/exclusives/99249 Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week. New Blood Tests for Cancer May Carry Risks New blood tests, which look for tiny shards of cancer DNA or proteins, are “a […]
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This appears to be from 2018, I find it interesting that the TXBOP will hold a PHARMACY responsible for the failure to detect patterns of inappropriate dispensing of prescription drugs is unprofessional practice and constitutes grounds for disciplinary action. A person/entity that has a pharmacy permit to operate a pharmacy, can only do so.. if […]
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Notice that this is a PBM (Express Scripts) is owned by the insurance company https://www.pharmacytimes.com/view/cigna-completes-purchase-of-express-scripts and has its own mail order pharmacy. Notice what was read from the letter from Express Scripts to the prescriber that they were MANDATING step therapy – step therapy is starting with the least expensive – or the PBM gets […]
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