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RADAR on Medicare Advantage
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As Medicare Advantage overpayments and coding practices face increasing scrutiny from the Medicare Payment Advisory Commission (MedPAC) and other stakeholders, the Washington Post editorial board...
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After months of legal battles, negotiations and political wrangling over contracts serving elderly and disabled Medicaid enrollees, the Arizona Health Care Cost Containment System (AHCCCS) reached...
HEALTH PLAN WEEKLY
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After the House Energy and Commerce and Ways and Means committees passed their portions of Republicans’ domestic policy bill on May 14, it appeared as though major changes to the Medicaid program...
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President Donald Trump’s administration is aiming to revive its so-called most favored nation (MFN) policy to reduce drug prices in the U.S. — a move that could lower costs for insurers but have far-reaching...
Radar On Speciality Pharmacy
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Although people who utilize specialty drugs represent only about 6% of commercially insured member populations, they contribute to more than half of the overall pharmaceutical spend....
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As fiduciaries, employers must act in the best interests of their employees and plan, but when it comes to biosimilars, some are not fully promoting them over higher-cost, rebatable reference drugs. During a...
RADAR ON DRUG BENEFITS
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Since 2019, Prime Therapeutics has tapped The Cigna Group’s Express Scripts to handle contracting negotiations with retail pharmacies, utilizing the larger PBM’s market power to get better deals for Blue...
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The first-quarter earnings calls held by the parent companies of the country’s three largest PBMs featured discussion about Arkansas’ new PBM law and developments related to GLP-1 medications, among other...
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AIS Health is a publishing and information company that has served the health care industry for more than 30 years. Our mission is to provide our readers with an actionable understanding of the business of health care and pharmaceuticals. Our in-depth writing covers the companies, people, catalysts and trends that create the richly textured contours of the health care and drug industry. AIS Health maintains journalistic independence from our parent company, MMIT. We are committed to integrity in reporting and bringing transparency to health industry data.
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