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PBMs

Budget, General Waste, Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Don’t Know Much About Algebra

06/12/2014 Elizabeth Wright

Paul Krawzak wrote in the June 4 Roll Call about some disturbing news that came from an April Congressional Budget Office (CBO) report on the Affordable Care Act (Obamacare.)  Said Krawzak, “In a little-noticed footnote to a report issued in April, ‘Updated Estimates of the Effects of the Insurance Coverage Provisions of the Affordable Care […]

Defense, Healthcare, PBM, PBMs, Pharmacy Benefits Manager

The Veterans Administration is a Socialized Healthcare System

06/11/2014 Elizabeth Wright

Who said the “VA is a socialized healthcare system?”  Or waxed poetically, “I know about a health care system that has been highly successful in containing costs, yet provides excellent care.  And the story of this system’s success provides a helpful corrective to anti-government ideology.  For the government doesn’t just pay the bills in this system — it runs the hospitals and clinics …The system in question is our very own Veterans Health Administration, whose success story is one of the best-kept secrets in the American policy debate?”  Or who declared the VA is a godsend?  And who promised that he’ll “make the VA a leader of national health care reform so that veterans get the best care possible?”

Defense, Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Fatally Long Waits and Red Tape

06/11/2014 staff

At the corner of Vermont Avenue and H Street in northwest Washington, D.C., a single structure’s exterior bears a bronze plate engraved with the words “To care for him who shall have borne the battle and for his widow, and his orphan.”  The building is the Department of Veterans Affairs, and the phrase, uttered by President Abraham Lincoln, is the agency’s motto.  Sadly, this goal is not being met, and, disappointingly, it hasn’t been for nearly a decade.

340B, Healthcare, PBM, PBMs, Pharmacy Benefits Manager

The Federal 340B Discount Drug Program Needs Reform

05/22/2014 Elizabeth Wright

The federal 340B drug discount program is in need of congressional oversight and reform.  

General Waste, Healthcare, PBM, PBMs, Pharmacy Benefits Manager

CAGW’s Obamacare Horror Stories

04/28/2014 Elizabeth Wright

You may remember Sen. Harry Reid’s (D-Nev.) infamous floor speech on February 26 regarding Obamacare Horror stories.  He said: Despite all that good news, there are plenty of horror stories being told.  All of them are untrue, but they are being told all over America… Those tales turned out to be just that – tales, stories […]

Commerce, Healthcare, Intellectual Property, International, PBM, PBMs, Pharmacy Benefits Manager, Technology, Telecommunications

World Intellectual Property Day Is April 26

04/24/2014 Deborah Collier

World Intellectual Property Day is April 26, 2014.  Set aside by the international community in 2000, as a day to increase and promote a general understanding of intellectual property (IP), this event is recognized worldwide at numerous events.  Among those events this year was the 2014 IP Champions Conference, held on April 23, 2014 by the […]

General Waste, Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Not So Fast — How Many Have Paid? How Many Were Previously Insured?

04/05/2014 Elizabeth Wright

“ACA Total Blows Past 7 Million!” “Obamacare Comeback?” “More Than Seven Million Have Enrolled Under the Affordable Care Act, Whitehouse says!” blare numerous April 1, 2014 newspaper headlines.  The president gave a speech in the White House Rose Garden stating, “Last night, the first open-enrollment period under this law came to an end.  And despite […]

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Medicare Fraud: All Talk, No Action

04/03/2014 Leslie Paige

The Medicare Trust Fund, which is in the red and on track to reach insolvency by 2026, needs every penny it can get.  Thanks to the Recovery Audit Contractor (RAC) program, $8.2 billion in improper Medicare payments has been recovered since its nationwide implementation in 2010.  RACs operate on a contingency fee basis, so their work does not cost taxpayers a dime.  Rather than celebrate this successful program, members of Congress, the Centers for Medicare and Medicaid Services (CMS), and special interests, particularly the hospital trade associations, are conspiring to kill it.

Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Showdown at Medicare Part D Corral

04/03/2014 Elizabeth Wright

Medicare Part D is one of the few government-created programs that has consistently cost less than the Congressional Budget Office’s (CBO) original estimates.  Every fall, seniors get to choose from a variety of plans for their drug coverage.  Pharmaceutical companies, pharmaceutical benefit managers (PBM), and pharmacies know this and they compete vigorously for seniors’ business.  A PBM is a third party administrator of prescription drug plans (Well-known PBMs are Catamaran, CVSCaremark, Express Scripts, Humana Pharmacy Solutions and USScript).  PBMs negotiate drug prices, establish formularies, process, and pay prescription drug claims in private insurance, as well as Medicare.  This robust competition among private sector entities is the major reason that Medicare Part D costs less than originally anticipated; rather than employing heavy-handed government edicts or price controls, market forces keep prices low and satisfaction high.  So, why would the Centers for Medicare and Medicaid Services (CMS) suddenly move to “fix something that ain’t broke”?    

General Waste, Healthcare, PBM, PBMs, Pharmacy Benefits Manager

Happy Birthday for Obamacare?

03/26/2014 Elizabeth Wright

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (Obamacare) into law.  The healthcare reform law is also known as the Affordable Care Act.  President Obama and Vice President Biden gave brief remarks during the signing ceremony.  Below are some of the statements and promises made by the president to the […]

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