Fierce Healthcare

JULY 26, 2023

In a largely harmonious Senate Committee on Finance markup hearing, members supported bipartisan efforts to rein in pharmacy benefit managers (PBMs) that they say operate without transparency to dr | The Senate wants to improve transparency surrounding pharmacy benefit managers and bring down prescription drug prices for the average person.

Prescription Drug Pricing 98

Prescription Drug Pricing 98

Healthcare It News

APRIL 28, 2022

"With prescription drug prices rising at every turn, patients need price transparency and the ability to discuss options with their doctors during office visits," Davis advised. ADVICE FOR OTHERS.

Prescription Drug Pricing 264

Prescription Drug Pricing Hospitals Medicare Medicare 264

Healthcare IT News - Telehealth

JANUARY 25, 2023

OptumRx launched Price Edge, a tool that compares pricing for traditional generic drugs to ensure members get the lowest prescription drug prices. It's a new year, and healthcare technology vendors are rolling out their latest innovations, market approvals, acquisitions and staffing shake-ups.

Prescription Drug Pricing 179

Prescription Drug Pricing Doctors FDA Health Insurance 179

Bill of Health

OCTOBER 7, 2022

New Reforms to Prescription Drug Pricing in the US: Opportunities and Challenges. Reforming Patient Cost Sharing for Cancer Medications in Medicare Part D. JAMA Oncol. 2022 Aug 4. Epub ahead of print. Hwang TJ, Kesselheim AS, Rome BN. 2022 Aug 19. Epub ahead of print. Lumpkin MM, Hamburg MA, Schultz WB, Sharfstein JM.

Prescription Drug Pricing 130

Prescription Drug Pricing FDA Medicare Medicare 130

HIT Consultant

APRIL 11, 2024

Prescription drug prices in the US are higher than in any other industrialized nation in the world. Convenience: The program connects patients with savings programs across over 70,000 pharmacies nationwide.

Prescription Drug Pricing 98

Prescription Drug Pricing Health Insurance 98

HIT Consultant

DECEMBER 5, 2023

This innovative approach will establish a transparent formula for drug cost and reimbursement, moving away from the traditional complex and opaque pricing structure.

Prescription Drug Pricing 98

Prescription Drug Pricing 98

Health Populi

OCTOBER 14, 2024

For Tier 3, only applicable to plans with three or more tiers, the average copay is $65 and coinsurance 35%; and, For Tier 4, again for plans with 3 or more tiers, the average copay is $128 and coinsurance a 33% share (generally applicable to specialty drugs).

Health Insurance 62

Health Insurance Prescription Drug Pricing COVID-19 Governance 62

Healthcare IT Today

APRIL 7, 2023

Real-time Prescription Benefit High prescription drug prices create affordability challenges for patients and the health care system as a whole.

US Department of Health and Human Services 111

US Department of Health and Human Services Prescription Drug Pricing Hospitals 111

HIT Consultant

SEPTEMBER 28, 2022

What You Should Know: – Prescryptive Health , a health tech company empowering consumers with prescription drug pricing data, has acquired Northwest Pharmacy Services Inc, a full-service, non-profit Pharmacy Benefit Manager. NWPS serves over 44,000 members in the Pacific Northwest.

Prescription Drug Pricing 52

Prescription Drug Pricing 52

Center for Health Insurance Reform

JANUARY 9, 2025

This month we read about prescription drug pricing and the impacts of rebates on consumers, as well as market shares of Medicare Advantage carriers. A snowy first week of January gave us plenty of time to read some of the last research from 2024.

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Prescription Drug Pricing Medicare Medicare 52

Jane Sarashon

FEBRUARY 27, 2024

In addition to highlighting the Patient’s Bill of Rights, NABIP’s keynotes and general sessions will speak to similar topics being brainstormed at VIVE this week — including mental health, maternal health, pharmacy and prescription drugs (pricing, PBMs), population health, and Medicare and Medicaid innovations.

ACA 118

ACA Prescription Drug Pricing Health Insurance Hospitals 118

HIPAA Journal

FEBRUARY 2, 2023

GoodRx is a Santa Monica, CA-based provider of a telemedicine platform that includes a free-to-use website and mobile app that consumers can use to track prescription drug prices and obtain coupons that provide discounts on medications. The platform can also be used to arrange telehealth visits and access other health services.

Prescription Drug Pricing 111

Prescription Drug Pricing HIPAA Compliance Telemedicine 111

Innovaare Compliance

JUNE 28, 2024

These requirements include: Detailed Reporting: Plans must submit comprehensive data on prescription drug pricing, utilization, and patient outcomes. Price Transparency: Increased transparency in drug pricing to enable beneficiaries to make informed decisions.

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Medicare Medicare Prescription Drug Pricing Compliance 94

Health Populi

JUNE 30, 2023

Take prescription drugs pushing medical trend upward.

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Prescription Drug Pricing COVID-19 ACA Hospitals 87

Jane Sarashon

DECEMBER 15, 2023

Entering 2024, we should be mindful that patients have been morphing into consumers, facing greater out-of-pocket costs and growing demand for omnichannel living and convenience, voting with their feet and clicks for, say, online appointments and access to health care which Zocdoc has pioneered for 16+ years.

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Prescription Drug Pricing Doctors 72

Health Populi

APRIL 24, 2019

This data point gives further impetus to prescription drug price hearings in Congress and various proposals promulgated on Capitol Hill to address the cost of medicines. ” Cost continues to be top-of-mind for healthcare consumers, who largely blame pharma first in the Edelman research.

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Prescription Drug Pricing Health Insurance Hospitals Governance 83

Kaiser Health News

MARCH 15, 2023

“We had a massive opioid problem that needed to be rectified,” said Antonio Ciaccia, president of 3 Axis Advisors , a consulting firm that analyzes prescription drug pricing. “But the federal crackdowns and guidelines have created collateral damage: patients left high and dry.”

Doctors 96

Doctors Prescription Drug Pricing FDA COVID-19 96

HIT Consultant

FEBRUARY 22, 2024

What You Should Know: Waltz Health, a digital health company developing smarter, technology-enabled ways to price, distribute and prescribe medications, today announced its entry into the Medicare market.

Medicare 52

Medicare Medicare Prescription Drug Pricing Health Outcomes 52

Healthcare Law Blog

JUNE 2, 2023

In the underlying Seventh Circuit cases, relators alleged that retail pharmacies had knowingly submitted false reports of their Usual and Customary (“U&C”) drug prices to the government for reimbursement under Medicare Part D and Medicaid, because the reports allegedly did not account for discounted drug prices offered through certain prescription (..)

Prescription Drug Pricing 52

Prescription Drug Pricing Governance Medicaid Medicaid 52

Health Law Advisor

MARCH 7, 2023

However, CMS’s release of the Initial Rebate Guidances represents the agency’s first significant opportunity to submit substantive and specific input from the broader stakeholder community with regard to one of the most significant components of the prescription drug pricing changes of the IRA.

Medicare 52

Medicare Medicare Prescription Drug Pricing Medicaid 52

Health Populi

OCTOBER 22, 2019

This latter point was emphasized in the survey noting that 71% of Americans said that drug prices were too high; 78% of people agreed that the government should be permitted to negotiate/regulate prescription drug prices.

Prescription Drug Pricing 54

Prescription Drug Pricing Health Insurance Doctors Governance 54

Health Care Law Brief

JANUARY 19, 2022

On December 31, 2021, New York Governor Kathy Hochul signed landmark legislation to increase the transparency of prescription drug pricing and to establish requirements on pharmacy middlemen.

Prescription Drug Pricing 52

Prescription Drug Pricing Licensing Compliance Medicaid 52

Health Populi

APRIL 25, 2023

middle-class households finding that health care has returned to the #1 household fiscal concern ahead of inflation in 2023.

Prescription Drug Pricing 62

Prescription Drug Pricing COVID-19 Hospitals Public Health 62

Jane Sarashon

JANUARY 24, 2023

Take Optum, which this week launched the Price Edge tool to help steer patients to the “lowest price generic medicines” according to the program’s press release. The price-comparison tool exclusively focused on generic drugs will be available to Optum Rx members.

Prescription Drug Pricing 59

Prescription Drug Pricing Hospitals Health Insurance 59

Health Populi

OCTOBER 28, 2019

When asked what factors contribute to rising health care costs in America, most consumers cite the cost of prescription drugs. Taken together, these two data points demonstrate the potent political import of prescription drug prices as the U.S. approaches the 2020 Presidential election.

Hospitals 54

Hospitals Prescription Drug Pricing Pharmaceutical Industry Medical Billing 54

Compliancy Group

SEPTEMBER 25, 2024

PBMs determine the prescription drug prices that insurers pay and the payments that pharmacies receive. PBMs also negotiate rebates and discounts from drug manufacturers for the health insurance plans they work with. PBMs wear many hats.

Prescription Drug Pricing 52

Prescription Drug Pricing HIPAA Compliance Health Insurance 52

Jane Sarashon

JULY 18, 2024

Health Populi’s Hot Points: Affording health care is a greater challenge for more Americans these days, the latest West Health-Gallup Health Care Affordability Index research revealed this week.

Doctors 59

Doctors Prescription Drug Pricing Hospitals Health Insurance 59

Health Populi

JANUARY 18, 2019

The top four health care issues consumers want Congress to prioritize in 2019 all deal with health care costs and access , for large majorities across political party ID: to lower prescription drug prices, to make sure insurers provide coverage for people with pre-existing conditions, to ensure Medicare benefits aren’t cut, and to lower the overall (..)

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Prescription Drug Pricing Health Insurance Doctors Medicare 66

Health Populi

OCTOBER 24, 2022

The XY supply demand curve shown above from Trilliant’s analysis illustrates a government price ceiling shock to health care pricing.

COVID-19 54

COVID-19 Prescription Drug Pricing Health Insurance Health Care Reform 54

Innovaare Compliance

JUNE 27, 2024

These requirements include: Detailed Reporting: Plans must submit comprehensive data on prescription drug pricing, utilization, and patient outcomes. Price Transparency: Increased transparency in drug pricing to enable beneficiaries to make informed decisions.

Medicare 52

Medicare Medicare Compliance Prescription Drug Pricing 52

HIT Consultant

NOVEMBER 8, 2022

Designed to shed light on the true cost of drugs and to ensure that consumers and insurers aren’t being gouged, drug pricing transparency laws seek to level the playing field by delivering greater visibility into drug costs.

Prescription Drug Pricing 52

Prescription Drug Pricing Compliance Governance 52

Kaiser Health News

MARCH 15, 2023

“We had a massive opioid problem that needed to be rectified,” said Antonio Ciaccia, president of 3 Axis Advisors , a consulting firm that analyzes prescription drug pricing. “But the federal crackdowns and guidelines have created collateral damage: patients left high and dry.”

Doctors 52

Doctors Prescription Drug Pricing FDA COVID-19 52

Healthcare Law Blog

FEBRUARY 22, 2023

All rebate payments will be deposited into the Medicare Prescription Drug Account in the Federal Supplementary Medical Insurance Trust Fund.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Fierce Healthcare

FEBRUARY 25, 2025

The executive order directs the Treasury and Labor departments and HHS to ensure hospitals and insurers "disclose actual prices, not estimates," and take action to make prices comparable across hospitals and insurers, including prescription drug prices.

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Prescription Drug Pricing Hospitals 123

Health Populi

OCTOBER 8, 2019

Pricing failure, the second big waste factor, is predominantly challenged by pharmaceutical/prescription drug pricing based on this research. The Centers for Medicare and Medicaid Services (CMS) forecasts that prescription drug spending will be the fastest-growing cause of rising health spending by 2027.

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Prescription Drug Pricing Medicare Medicare ACA 108

HIT Consultant

JANUARY 21, 2022

Anyone with a December 2021 LG TV or newer can access affordable medications via the Capital Rx Advantage prescription savings card, downloaded directly from the comfort of their own homes via the Independa Health Hub (automatically on all LGTVs. It beats other popular discount cards on prices 80% of the time.

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Prescription Drug Pricing Medicare Medicare 95

Health Populi

JANUARY 27, 2021

health citizens support attacking COVID-19 through testing, federal support for vaccines, expanding telehealth, expanding the ACA, and reforming (lowering) prescription drug prices. Ultimately, U.S. For the details, check out the post on the Medecision site.

Governance 71

Governance COVID-19 Prescription Drug Pricing ACA 71