Medicare Part D plans that create tiered networks of pharmacies for beneficiaries need more oversight amid reports that small and medium-sized pharmacies are being excluded from them, several senators wrote in a letter last week to the Centers for Medicare and Medicaid Services.
Bipartisan legislation that would let pharmacists devote more time to Medicare beneficiaries and less to adjudicating claims with pharmacy benefit management firms was introduced in the U.S. Senate and won the backing of the National Community Pharmacists Association earlier this week.
CareFirst BlueCross BlueShield has entered into a three-year agreement with CVS Caremark to provide pharmacy benefit and other related services to its commercial and Medicare Part D members, CareFirst announced earlier this week.
Unnecessary spending related to medications totaled nearly half a trillion dollars last year, and much of that was in the poorest states in the country, according to pharmacy benefit manager Express Scripts.
DSN spoke at length with two Catamaran executives — Albert Thigpen, SVP pharmacy operations and industry relations, and Sumit Dutta, SVP and chief medical officer — about the PBM’s new approach to managed pharmacy care and the changes driving that strategy.
The governor of North Dakota has signed into law a bill that would require pharmacy benefit managers to inform pharmacies about how reimbursement for generic prescription drugs is calculated under maximum allowable cost benchmarks and provide a more detailed appeals process to pharmacies to contest the MAC reimbursement caps that PBMs set up.
Kentucky became the first state to enact legislation that provides pharmacists with transparency into how health plans determine pharmacy reimbursements for generic drugs, and establishes an appeals process when a dispute arises over those payment levels.
The National Community Pharmacists Association endorsed H.R. 1188, legislation introduced by U.S. Reps. Tom Marino, R-Pa., and Judy Chu, D-Calif., that would allow independent community pharmacies to collectively negotiate.
Bills introduced in Oregon's state legislature would allow employers and other health plan sponsors to have greater knowledge about how pharmacy benefit managers determine the rates at which they pay pharmacies for dispensing generic drugs; establish new standards for pharmacy audits while requiring PBMs to register in the state and be licensed by the state board of pharmacy; and prevent health plans from requiring residents of the state to use mail-order pharmacies.
The National Community Pharmacists Association joined the North Dakota Pharmacy Association in support of a pharmacy benefit manager transparency bill that was passed by the state assembly by a vote of 93-0 on Feb. 25.
The National Community Pharmacists Association on Wednesday submitted a statement for the record to the U.S. House Energy and Commerce Health Subcommittee for its hearing on “Fostering Innovation to Fight Waste, Fraud and Abuse in Health Care.”
The generic drug tidal wave became a tsunami in 2012, with some of the world's top-selling pharmaceuticals swamped by generic competition, and health plan payers scrambling to reap billions of dollars in financial savings.
Legislation that would require pharmacy benefit managers to seek licensure from the Oklahoma State Board of Pharmacy if they were to distribute medicines to Oklahoma residents was introduced on Tuesday, according to an AP report.
Anthem Blue Cross will indefinitely suspend a policy that would require many specialty pharmacy patients in California, most of them HIV patients, to receive their drugs via mail order in order to receive coverage for them, drawing criticism from patients and retail pharmacies.