
By Susan Rupe
Anthem Blue Cross Blue Shield is backing down from a plan that would have set limits on the amount of time it would pay for anesthesia in certain surgeries.
Continue reading Anthem BCBS Backs Down On Plan To Limit Anesthesia CoverageBy Susan Rupe
Anthem Blue Cross Blue Shield is backing down from a plan that would have set limits on the amount of time it would pay for anesthesia in certain surgeries.
Continue reading Anthem BCBS Backs Down On Plan To Limit Anesthesia CoverageBy Bolton • December 5th, 2024 SOURCE: https://www.boltonusa.com/deadline-for-submitting-gag-clause-attestation-is-dec-31-2024/
Effective in 2020, the Consolidated Appropriations Act, 2021 (CAA) prohibits health plans and health insurance issuers from entering into contracts with health care providers, third-party administrators (TPAs) or other service providers that contain gag clauses (i.e., clauses restricting the plan or issuer from providing, accessing or sharing certain information about provider price and quality and de-identified claims).
Continue reading Deadline for Submitting Gag Clause Attestation Is Dec. 31, 2024Ivan Unger and Gladys Roy were the two responsible for this jaw-dropping stunt on the wings of a biplane in 1925. The two were successful in playing what has to have been the most dangerous game of tennis ever played and, as biplanes are a thing of the past, a stunt like this is unlikely ever to be pulled off again.
Continue reading Need Accident Insurance?Few have the willpower required for diet discipline and look to Will Power medication for a cure.
Continue reading The Kennedy Wellness Program or Will Power Medication?Alleged Carrier Fraud, Direct Primary Care and Which Companies Best Reference-Base Price
“Bundling self-funded plans with a carrier as your TPA, network, and PBM? A recipe for disaster. If you’re large enough to self-fund, don’t bundle. Period.
Continue reading Craig Gottwals OpinesTexas Procurement and Contract Management Guide :
“A Request for Qualifications (RFQ) is generally used for professional services wherein the respondents are evaluated based solely on their qualifications and skills.”
Continue reading Tx. Gov’t Code: Request For QualificationsThe NYPD confirmed the shooting, which cut UnitedHealth’s investor conference short on Wednesday morning, though not Thompson’s identity. Thompson, 50, had been with UnitedHealth since 2004.
Continue reading UnitedHealthcare CEO Brian Thompson MurderedI have been working as a fee-based health insurance consultant for more than 25 years. The other day I was visiting with a wholesale broker and asked him how much do brokers make these days. He works with all the big houses and a whole lot of mom and pops.
Continue reading How Much Do Health Insurance Brokers Make?I called to get the cash price for an urgent care visit. And they pulled the ole’ Abbott and Costello “who’s on first base? And yes, these ladies I spoke with were rude and condescending to me.
Continue reading Sanford Health Is A Federal OutlawBy Adam Berkowitz
Humira (WAC): $6,922
After Rebate: $4,922
Amjevita: $1,385
Yusimry: $995
Abrilada: $1,038
Hadlima: $1,038
adalimumab-aaty: $275
Continue reading Plan Sponsors Still Covering Humira Are Overpaying“I used to drink 99 beers but now only one does me just fine!”
Dizzy after one drink? Social drinkers on obesity drugs lose the taste for alcohoL Many social drinkers who take obesity medications, such as Wegovy or Mounjaro, say they don’t enjoy alcohol as much.
Continue reading No Thanks. One Beer is Enough!SOURCE: PHARMPIX
A “virtual” full service PBM with an adaptable business model for different pharmacy delivery solutions. Establish a deeper connection with your beneficiaries and providers and save along the way.
Continue reading pharmpix – A Virtual Full Service PBMNADAC pricing is gaining traction in the PBM industry due to its role in pricing transparency, reimbursement negotiations, cost management, formulary management, regulatory compliance, and alignment with industry trends. It offers a standardized benchmark for drug pricing, promoting fairness and transparency in the healthcare system.
Continue reading Are You NADAC Ready? Staying Ahead of the Drug Pricing LandscapeLife insurance for people with diabetes, cancer, heart conditions and other deadly diseases?
Continue reading Life Insurance For DiabeticsReport details how prescription drug middleman profit at the expense of patients by inflating drug costs and squeezing Main Street pharmacies…….details how increasing vertical integration and concentration has enabled the six largest PBMs to manage nearly 95 percent of all prescriptions filled in the United States.
Continue reading FTC Report on PBM Consolidation“This case is about disability discrimination in the provision of healthcare coverage. Specifically, this case is about a health insurance company’s categorical exclusion of prescription medication for the treatment of obesity and the resultant discrimination against people with the disability of obesity.”
Continue reading Class Action Lawsuit Challenges Noncoverage of Obesity Drugs