Humana
Ohio AG files antitrust suit against Express Scripts, Humana, others
In a development that is likely shaking the world of health insurance, Ohio Attorney General Dave Yost on Monday sued six corporate entities over the way they facilitate drug transactions. Yost filed the suit under the Valentine Act — Ohio’s antitrust law — accusing the companies of improperly colluding to fix prices and other actions […]
Feds to probe drug rebates
The Federal Trade Commission last week announced what some observers believe could be a game-changer when it comes to the rising cost of prescription drugs. The agency — which is meant to protect fair competition — said it would look into the murky practice by which drugmakers grant rebates and other fees to insurer-owned pharmacy […]
Medicaid director owned stock in companies she awarded huge contracts
Ohio Medicaid Director Maureen Corcoran won’t discuss them, but state ethics filings she submitted on Sunday showed that she continued to own stock in three huge health care companies last year — the same year she negotiated and signed billion-dollar contracts with their subsidiaries. Outside ethics experts have said it’s a clear conflict of interest […]
Government watchdog: Health care giants improperly denied Medicare benefits
The health care companies offering Medicare Advantage plans improperly denied services and payments at what might seem an alarming rate during a one-week test period in 2019, according to a government report released last week. The companies — many of which are also major players in the Ohio Medicaid system — improperly denied payment 18% […]
For one drug at least, biggest insurers force Medicare patients to buy the most expensive
In theory, the point of managed care is to save money by negotiating with providers for lower prices. So it would seem that the biggest managed-care providers would use their clout to negotiate the lowest prices from doctors and hospitals and for medicine. But for at least one drug, the largest Medicare managed-care companies are […]
Ohio Medicaid: It’s not a conflict if you only own stock in the parent company
Ohio Medicaid Director Maureen Corcoran didn’t have a conflict of interest when she signed multi-billion-dollar contracts earlier this year, her department’s attorneys are arguing. That’s because she only owns stock in parent corporations — not their Ohio subsidiaries to whom she awarded contracts. The department made the argument in a Friday motion in a court […]
Firm that facilitated $22B in contracts won’t say if any went to its clients
When the Ohio Department of Medicaid this year selected six companies to manage $22 billion worth of managed-care business, it was supposed to be a competitive process. But some pretty big questions linger about how competitive it actually was. Somehow, an Ohio-based company was dinged because it hadn’t worked outside the Buckeye State. But giant, […]
State says Medicaid director complied with ethics law, won’t share documents
The Ohio Department of Medicaid and the governor’s office last week insisted that Medicaid Director Maureen Corcoran complied with state ethics laws as her department entered into massive contracts earlier this year. However, they so far have refused to produce copies of affidavits that seem to be required by state law, and Corcoran is refusing […]