Centene has rebutted the accusations made in a sealed lawsuit filed by the Ohio attorney general that accused the insurer of over-billing the state’s Medicaid department. The lawsuit is based on a misunderstanding of how Medicaid billing operates and should be unsealed, Centene said.
pharmacy benefit managers
The Ohio attorney general has filed a lawsuit alleging that a Centene subsidiary, which provides Medicaid services in the state, hired multiple companies to administer pharmacy benefits in order to inflate costs. As a result, the state’s Medicaid department paid millions in overcharges.
The Senate Finance Committee has released a new report detailing findings of their investigation into the role that market dynamics play in the pricing of insulins. The report conclusions further solidify what we already know: perverse incentives in the market drove up insulin costs for… Read More »New insulin report highlights how incentives benefit middlemen, harm patients
While drug middlemen are making billions of dollars in record profits at a time when millions of Americans are facing financial struggles, they are also suing to block the final rebate rule, a policy to lower out-of-pocket drug costs for patients. The fact is that… Read More »Key facts: The final rebate rule will be a positive change for patients
To reduce drug prices, we should focus on the complex drug channel arrangements that stand between manufacturers and patients and not as much on price controls.
WithMe Health, a startup trying to build a new approach to pharmacy benefits, spun off a medication guidance service that can be layer on top of existing PBMs. It also raised $20 million in funding, led by OMERS Ventures.
Opioid overutilization is a public health crisis, and PBMs with programs aimed at curbing abuse and educating providers can have a positive and substantial impact on clients and their members.
In response to the Request for Input on Modernizing the 340B Drug Pricing Program issued by Representative Greg Walden and Senator Lamar Alexander, PhRMA has outlined a number of commonsense ways policymakers can get the 340B program back on track and refocused on patients.
A new study from Xcenda finds that from 2014 to 2020, the number of medicines excluded by at least one of the three largest pharmacy benefit managers (PBMs) from their standard formularies increased by an average of 34% per year. As a result, each year… Read More »Study finds middlemen excluded nearly 850 medicines from formularies this year
By JESSICA DaMASSA, WTF HEALTH A startup PBM? Partnered up with Walmart to bring “everyday low prices” to prescription drug pricing? Is this too good to be true? A.J. Loiacono, founder & CEO at Capital Rx, gives us a quick primer on “Pharmacy Benefit Managers”… Read More »PBM Startup Capital Rx Starts Prescription Drug Pricing Shake-Up with Walmart Partnership