Maine Enacts Canadian Reference Pricing Law to Study Savings in Prescription Drug Costs

“Maine’s Democratic governor, Janet Mills, signed legislation directing the Maine Health Data Organization (MHDO) to report annually on the potential savings if certain drugs were subjected to a referenced rate, which is the lowest of the prices available among Canada’s four largest provinces and the wholesale acquisition cost, beginning January 1, 2023.”  MORE >>

Continue reading Maine Enacts Canadian Reference Pricing Law to Study Savings in Prescription Drug Costs

Direct Provider Contracts Will Be Secret No More……….

A reference based pricing plan having direct provider contracts is by definition a “network” plan. (See definition of “in-network” in Code of Federal Regulations, 147.210, XII) In that instance a plan sponsor must publicly display in-network information containing name, CPT code and negotiated rate and fee schedule rates.

Continue reading Direct Provider Contracts Will Be Secret No More……….

Solving Health Care Inspires School Official To Earn Doctorate Degree

“I successfully defended my dissertation titled: A CASE STUDY OF GROUP HEALTH INSURANCE COVERAGE AT ONE TEXAS SCHOOL DISTRICT, earning an Ed.D. from Lamar University. My dissertation was a single case study of group health insurance coverage at Raymondville ISD. “ – Ben Clinton

Continue reading Solving Health Care Inspires School Official To Earn Doctorate Degree

Santa Claus Fixes The Family Glitch Using Other People’s Money

The Department of the Treasury (Treasury) notice of proposed rulemaking on the “family glitch” expands eligibility for free government money to employees’ families when their share of their employer-sponsored premium is deemed to be unaffordable by  faceless bureaucrats in Washington.

Continue reading Santa Claus Fixes The Family Glitch Using Other People’s Money

Hospital Fair Share Spending

“Recently we asked a not-for-profit hospital for a copy of their Financial Assistance Policy. Instead they directed us to their website where, they said, we could find all we needed to know about their Financial Assistance Policy. We did, and it didn’t. So we asked the hospital a second time for a complete copy of their Financial Assistance Policy. To date they have not responded. So, it’s been over 30 days now and it’s time to file a complaint with the proper federal authorities to remove their not-for-profit status. They can’t have their cake and eat it too” – Bill Rusteberg

Continue reading Hospital Fair Share Spending