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A big win for PBMs (and self-funded health plans) in Oklahoma appeals court ruling

By Scott Wooldridge

A federal appeals court has ruled that pharmacy benefit managers are subject to ERISA, thereby PBMs working for state plans with rural employees must include brick-and-mortar pharmacies as well as mail-order pharmacies.

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News

Walgreens CEO departs, to be replaced by exec with 'deep health care experience'

Research

Employers need to step up: Insist on high-quality health care, says report

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Consumer Driven Health Care Stories

September 01, 2023

CMS: States, fix the 'glitch' in the system that drops eligible children from Medicaid

The Centers for Medicare & Medicaid Services sent a letter to Medicaid directors in all 50 states, requiring them to determine whether they have an eligibility systems issue that could cause children to be dis-enrolled from Medicaid.

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August 31, 2023

Restricted access to specialty drugs on the rise: What employers, advisors need to know

Employers, benefit advisors and brokers need to consider that these restrictions can hinder patient access to the treatments their clinicians prescribe and worsen their outcomes while increasing health care costs, says a new study.

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August 31, 2023

Drugstore disruptors? Walmart, CVS want patients to skip trips to the doctor

The big chains are angling for a larger slice of health care spending as new state laws allow pharmacists to treat minor ailments.

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August 30, 2023

Drug price negotiations are on: 5 things to know about the impact on the industry

Even though six drug companies have filed lawsuits to halt the Medicare drug negotiation program, the companies have until Oct. 2 to present data on their drugs to CMS, which will make initial price offers in February.

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August 29, 2023

'Conspiracy!' Medical providers sue credit bureaus for omitting unpaid bills under $500

A group of medical providers filed a lawsuit against Experian, Equifax and TransUnion, alleging they conspired to omit small unpaid medical bills from their reports, which places them at a severe disadvantage compared to hospitals.

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August 29, 2023

First 10 drugs set for Medicare price negotiations: Will pharma participate?

Blood clot drugs Eliquis and Jardiance made the list, released on Tuesday, amid lawsuits filed by their manufacturers, attempting to block the government's effort to control drug prices.

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August 29, 2023

Tripledemic ahead! New COVID, flu, RSV vaccines (and what's covered by insurance)

Timing and cost of new vaccines vary by virus and health insurance status, but for COVID shots, including the updated ones expected to be available this fall, most people will still be able to get the vaccines for free.

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Consumer Driven Health Care

Top Consumer Driven Health Care Stories

A big win for PBMs (and self-funded health plans) in Oklahoma appeals court ruling

Walgreens CEO departs, to be replaced by exec with 'deep health care experience'

Employers need to step up: Insist on high-quality health care, says report

Recommended Just For You

Consumer Driven Health Care Stories

CMS: States, fix the 'glitch' in the system that drops eligible children from Medicaid

Restricted access to specialty drugs on the rise: What employers, advisors need to know

Drugstore disruptors? Walmart, CVS want patients to skip trips to the doctor

Drug price negotiations are on: 5 things to know about the impact on the industry

'Conspiracy!' Medical providers sue credit bureaus for omitting unpaid bills under $500

First 10 drugs set for Medicare price negotiations: Will pharma participate?

Tripledemic ahead! New COVID, flu, RSV vaccines (and what's covered by insurance)