May 11, 2023 | Centers for Medicare & Medicaid Services (CMS), Compliance, Consolidated Appropriations Act of 2021 (CAA), Pharmacy, Prescription, Regulatory
You might remember that the Consolidated Appropriations Act of 2021 (CAA) requires all health plans to file a pharmacy data report annually to the Centers for Medicare & Medicaid Services (CMS). Beginning this year, and each year thereafter, that reporting must be...
Apr 17, 2023 | biologics, Biosimilars, Brand Name Drugs, Cost Savings, Generic Drugs, Pharmacy, Prescription, Rx Costs, Savings
Much like generics are lower-cost equivalents of more expensive drugs, so too are biosimilars. But there’s a notable distinction between the two. Generics contain the exact same active ingredients as their brand-name counterparts and are usually synthesized from...
Apr 3, 2023 | Lawsuits, News, Ohio, Pharmacy Benefits Manager (PBM), Prescription, Regulatory, State legislation
Ohio Attorney General David Yost has sued pharmacy benefit managers (PBMs) Express Scripts and Prime Therapeutics for conspiring to illegally increase prescription drug prices and force pharmacies to accept low reimbursement rates. Cigna Group and Humana were also...
Mar 21, 2023 | Brand Name Drugs, Diabetes, Drug costs, Generic Drugs, Insulin, Kurt Harden, MedBen Rx, MedBen University, Pharmacy Benefits Manager (PBM), Prescription
Earlier this month, drug manufacturer Eli Lilly announced that it cutting the cost of two of its prescription brand insulins, Humalog and Humulin, by 70%, and capping out-of-pocket costs for privately insured patients at $35 a month. Competing drugmakers Novo Nordisk...
Feb 17, 2023 | Affordable Care Act, Birth Control, Compliance, News, Prescription
On February 2, 2023, the Departments of Labor, Health and Human Services, and Treasury (the “Tri-Agencies”) proposed a rule to expand women’s access to birth control under the Affordable Care Act (ACA). The proposed rule revises the exemption allowances...
Feb 3, 2023 | Alternative Reimbursement Strategies, Claims, Cost Savings, Direct-to-Employer Contracting, Drug costs, Forensic claims review, Gene therapy, Health care costs, Inflation, MedBen Rx, MedBen WellLiving, Prescription, Rx Costs, Savings, Specialty Drugs, Wellness
Even though health care costs have not seen the same rate of inflation as other industries, that’s about to change. Fortunately, MedBen has a variety of inflation-hedging solutions to counter rising costs. As a recent Self-Insurer article notes, health care...
