May 16, 2023 | Alternative Reimbursement Strategies, Announcements, Case Studies, Client Report, Client Services, Client Surveys, Communication, Compliance, Cost Plus Pricing, Cost Savings, Direct-to-Employer Contracting, Drug costs, Forensic claims review, HealthJoy, Inflation, Kurt Harden, MedBen Rx, MedBen WellLiving, Member engagement, Mobile App, Online Services, Own Use, Pharmacy, Pharmacy Benefits Manager (PBM), Plan Design, Plan Language, Prescription, Reference-Based Pricing, Regulatory, Rx Costs, Savings, Self-funding, Specialty Drugs, Supreme Court, Wellness
The 2023 MedBen Client Report is now available to download from MedBen.com! In his opening note, MedBen President Kurt Harden states: “This Client Report is designed to demonstrate ways that clients can generate greater value from their health plan. With health...
May 11, 2023 | Centers for Medicare & Medicaid Services (CMS), Compliance, Consolidated Appropriations Act of 2021 (CAA), Pharmacy, Prescription, Regulatory
You might remember that the Consolidated Appropriations Act of 2021 (CAA) requires all health plans to file a pharmacy data report annually to the Centers for Medicare & Medicaid Services (CMS). Beginning this year, and each year thereafter, that reporting must be...
Apr 17, 2023 | biologics, Biosimilars, Brand Name Drugs, Cost Savings, Generic Drugs, Pharmacy, Prescription, Rx Costs, Savings
Much like generics are lower-cost equivalents of more expensive drugs, so too are biosimilars. But there’s a notable distinction between the two. Generics contain the exact same active ingredients as their brand-name counterparts and are usually synthesized from...
Apr 3, 2023 | Lawsuits, News, Ohio, Pharmacy Benefits Manager (PBM), Prescription, Regulatory, State legislation
Ohio Attorney General David Yost has sued pharmacy benefit managers (PBMs) Express Scripts and Prime Therapeutics for conspiring to illegally increase prescription drug prices and force pharmacies to accept low reimbursement rates. Cigna Group and Humana were also...
Mar 21, 2023 | Brand Name Drugs, Diabetes, Drug costs, Generic Drugs, Insulin, Kurt Harden, MedBen Rx, MedBen University, Pharmacy Benefits Manager (PBM), Prescription
Earlier this month, drug manufacturer Eli Lilly announced that it cutting the cost of two of its prescription brand insulins, Humalog and Humulin, by 70%, and capping out-of-pocket costs for privately insured patients at $35 a month. Competing drugmakers Novo Nordisk...
Feb 17, 2023 | Affordable Care Act, Birth Control, Compliance, News, Prescription
On February 2, 2023, the Departments of Labor, Health and Human Services, and Treasury (the “Tri-Agencies”) proposed a rule to expand women’s access to birth control under the Affordable Care Act (ACA). The proposed rule revises the exemption allowances...
