Tom Mirga
Editor at Large
A new “playbook” for employers on getting the upper hand with pharmacy benefit managers says PBM handling of 340B drugs is a top 10 concern for business-sponsored health plans.
Released yesterday by the Washington, D.C., based National Alliance of Healthcare
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Laura Gilcrest
Editor at Large
The Iowa Senate last week passed a House-approved bill banning pharmacy benefit manager and payor discrimination against 340B covered entities and their contract pharmacies, including reimbursing the entities at a lower rate than non-340B providers.
The Senate voted 49-1 on
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New Mexico Gov. Michelle Lujan Grisham (D) signed a law April 7 to prevent pharmacy benefit managers and insurers from discriminating against 340B providers. The bill includes language that prohibits payers from reimbursing 340B covered entities at a lower rate
… Tom Mirga
Editor at Large
Two Republican U.S. senators expressed concerns about pharmacy benefit manager encroachment on 340B covered entity savings during a Senate Finance Committee hearing on PBMs last week.
“I often hear concerns from South Dakota hospitals and health centers when it comes
… Laura Gilcrest
Editor at Large
The U.S. House Committee on Oversight and Accountability last week launched an investigation into how “anticompetitive tactics” by the three largest pharmacy benefit managers—Express Scripts, CVS Caremark, and OptumRx—are driving up healthcare costs and hurting patient care within federal health
… Laura Gilcrest
Editor at Large
Oregon legislators have introduced a bill that would prohibit discriminatory practices by pharmacy benefit managers and insurance plans against 340B pharmacies, including reimbursing a 340B pharmacy less for prescription drugs compared with non-340B pharmacies.
If passed later this year, House
… Sarah True
Editor at Large
A federal district court in Arizona has upheld a $23 million arbitration award to the AIDS Healthcare Foundation (AHF) against pharmacy benefits manager (PBM) CVS Caremark for unfair drug reimbursement.
In its November 2019 lawsuit, AHF alleged that CVS Caremark
… Sarah True
Editor at Large
Tom Mirga
Editor at Large
UPDATE Wednesday, June 22, 2022, 2:50 p.m. EDT—CVS Health issued this statement: “We do not comment on specific PBM client contract terms. Our clients are sophisticated purchasers, and we work closely with them to customize a benefit design meeting their
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