From Managed Healthcare Executive Introduction: The COVID-19 pandemic has had a deep and profound impact on American businesses both large and small. As the country inches back to a “new normal,” business leaders have to deal with the cost of healthcare as a significant issue to their bottom line. Managing pharmaceutical costs will continue to [...]

From Modern Healthcare "A recently unsealed False Claims Act lawsuit against CVS Health claims the company, through its pharmacy benefits manager unit, illegally billed Medicare for higher prices than it was actually paying pharmacies." Senior actuary at Aetna, Sarah Behnke, estimates that CVS Caremark hid around $1.5 billion in just the 2014 calendar year. This [...]

From FirecePharma Multiple class-action lawsuits have been recently filed against CVS and Walgreens. The plaintiffs are claiming the pharmacies overcharged them for their generic drug prescriptions. The suits argue that the consumers would have been better off paying for the generic medications without using their insurance. The article goes on to further explain how the [...]

From CNBC CVS has been ordered to cooperate with an investigation looking into false claim submissions and their pricing of insulin and epinephrine drugs. The article also describes a proposed class action lawsuit  pertaining to the increased prices of insulin against Sanofi, Eli Lilly & Co., and Novo Nordisk. Click here to learn more.

From AHIP This article provides an excellent visual representation of how your health insurance premium dollars are spent. The article, by Krisit Wick shows that 80% of every premium dollar goes towards medical expenses. Click here to read the full article and learn what the rest of your dollar is paying for.

Antitrust regulators’ skepticism could spell a big loss for Anthem[…]

On a daily basis we are asked about medications that are covered under Medicare Part B and billed under medical benefits. Medications requiring Prior Authorization[…]