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PBMs

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

They’re Baaaaack – The Sequel

01/12/2019 Elizabeth Wright

In their never-ending quest to run roughshod and exert control over the research-intensive biopharmaceutical industry, socialists in Congress have introduced various price-control bills.  For some reason they continue to think innovative drugs that cure cancer or other chronic diseases, such as hepatitis C, are whipped up in a back room with a 1970s-style “Mr. Wizard’s […]

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Stay Calm and Carry On

12/20/2018 Elizabeth Wright

On Friday, December 14, U.S. District Judge Reed O’Connor ruled in Texas, et al v. United States, et al, that the Patient Protection and Affordable Care Act (ACA), or Obamacare, was unconstitutional.  The hysteria immediately began, with Senate Minority Leader Chuck Schumer (D-N.Y.) stating, “This is an awful ruling.  Of course, it undoes pre-existing conditions, […]

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Using an International Pricing Index is NOT the Way to Lower Drug Costs

12/15/2018 Elizabeth Wright

On December 6, John O’Brien, the senior advisor on drug pricing reform to Health and Human Services (HHS) Secretary Alex Azar, published a blog, entitled, “How the IPI Model Would Introduce New Market Competition to Medicare Drug Spending.”  The blog left a lot of fiscal conservatives and patient-centered, free-market healthcare advocates scratching their heads.  Mr. […]

Budget, Healthcare, PBM, PBMs, Pharmacy Benefits Manager

HHS OIG Admits: We’re Just Flushing Money Down the Drain

12/12/2018 Leslie Paige

The U.S. Department of Health and Human Services Office of the Inspector General (OIG) admitted last week that the Centers for Medicare and Medicaid Services (CMS) hospital payment process is broken. The OIG’s report, “Significant Vulnerabilities Exist in the Hospital Wage Index System for Medicare Payments,” showed that from 2004 to 2017, CMS overpaid nearly […]

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

More Good News from Trump Administration on Lowering Health Insurance Costs

12/05/2018 Elizabeth Wright

It’s a common saying in D.C., that bad news gets released on Fridays.  But, that was not the case on Friday, November 30, 2018.  Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma announced that her agency was releasing four waiver concepts to help governors and state legislatures take advantage of Section 1332, Waiver […]

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Healthcare Moves from the Election and Back to Congress

11/20/2018 Elizabeth Wright

Poll, after poll, after poll shows that healthcare was the top issue in the 2018 elections.  This should not be a surprise as Democrats ran on the issue, while many Republicans hid from it. That’s too bad because the Trump administration has been doing a lot via regulations and guidance to create more choices and […]

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

In 2019, More Options Available to Save on Health Insurance

11/03/2018 Elizabeth Wright

Once again, open enrollment began for the Patient Protection and Affordable Care Act (ACA), better known as Obamacare.  The time frame to enroll is from November 1, 2018 to December 15, 2018 for coverage in 2019. There should be no surprise that individuals will discover once again, without government subsidies, the price of health insurance […]

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Adopting Foreign Countries’ Price Controls: A Really Bad Idea

11/01/2018 Elizabeth Wright

Citizens Against Government Waste (CAGW) was troubled and mystified when the Trump administration issued an advanced notice of proposed rulemaking that would change Medicare Part B reimbursement for outpatient drugs from the Average Sales Price (ASP) plus 6 percent to instead a reimbursement system based on what other countries pay for the same drugs.  The […]

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Trump Administration Implements New Guidance to Help Fix Individual Health Insurance Market

10/22/2018 Elizabeth Wright

Except for a few noteworthy successes, such as repealing the individual mandate that forced people to buy health insurance they did not want or could afford, and ridding us of the Independent Payment Advisory Board that turned Medicare over to unelected bureaucrats, Congress has remained almost at a standstill when it comes to fixing and […]

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

New HHS Transparency Regulation Mandates Inaccurate Information

10/18/2018 Elizabeth Wright

The Pharmaceutical Research Manufacturers Association (PhRMA), the trade association that represents the nation’s leading biopharmaceutical research companies, announced a new proposal on Monday regarding direct-to-consumer (DTC) television advertising.  This voluntary agreement by PhRMA members would help patients access more useful information about the cost of their medicines. In 2006, the association adopted a series of […]

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