pharmacy benefit managers

Ohio’s Medicaid director owns the stock of some major contractors, but won’t say how much

BY: - October 6, 2021

Since she became director of the Ohio Department of Medicaid in January 2019, Maureen Corcoran has owned stock in some of the department’s biggest contractors. Given the size of those contracts, they could have increased the value of the stock Corcoran owned. But while she complied with one set of state disclosure requirements, Corcoran won’t […]

Biden administration announces “comprehensive” plan to fix high drug prices

BY: - September 13, 2021

The U.S. Department of Health and Human Services last week issued its plan to address high drug prices as part of President Joe Biden’s push to take on anticompetitive practices across the economy. But while it addressed in detail abusive practices by drugmakers, it was a lot more superficial about the practices of much-larger corporations […]

In court, drug middlemen fight to limit pharmacies insured patients can use

BY: - September 7, 2021

In the first test of a 2020 U.S. Supreme Court ruling, drug middlemen last week argued that federal law gives them a crucial right to limit what pharmacies patients with health insurance can use — or at least make it more expensive if patients get their medicine at a shop that isn’t preferred by the […]

Already concerned with drug costs, large employers, family pharmacists worry about more middlemen

BY: - September 2, 2021

There already were deep concerns among small pharmacists about drug middlemen known as "pharmacy benefit managers."  Now the corporations that own them appear to be creating yet another layer of middlemen. That has even the largest employers in the country worried.

How info likely leading to massive settlement almost stayed hidden

BY: - August 31, 2021

It seems to be an object lesson in the importance of government transparency. Revelations that quite possibly led to a lawsuit and a billion-dollar settlement by the nation’s largest Medicaid managed-care provider almost never came to light, according to court documents filed last month. Meanwhile, huge drug middlemen are fighting to keep sealed damning information […]

Ohio Medicaid chief dodges when asked to explain business with company AG said “fleeced” taxpayers

BY: - August 26, 2021

Ohio Medicaid Director Maureen Corcoran didn’t give many straight answers Wednesday when she was pressed about why her agency restarted a massive contract with a company that earlier this year was accused of “fleecing” taxpayers out of tens of millions of dollars. At one point, Corcoran even invoked lawyer-client privilege to avoid answering a question. […]

Drug-pricing practice could be banned to help pay for infrastructure bill

BY: - July 29, 2021

Drug-pricing practice could be banned to help pay for infrastructure bill.

Drug-pricing reform might fall victim to infrastructure negotiations

BY: - July 21, 2021

As lawmakers attempt to salvage a bipartisan infrastructure package, new rules intended to crack down on secretive prescription-drug transactions might fall by the wayside.

Ohio AG signs on to important pharmacy middleman case

BY: - July 20, 2021

Ohio Attorney General Dave Yost has joined a lawsuit testing states’ power to regulate powerful middlemen who control the way prescription drugs are managed. Yost last week notified the 8th U.S. Court of Appeals in St. Louis that Ohio was joining 30 other states who are urging the court to uphold North Dakota laws meant […]

Big PBM decision undergoes its first test

BY: - July 9, 2021

The stakes appear to be pretty high. After a unanimous ruling in a related case in December, the U.S. Supreme Court has reopened a case regarding sweeping regulations of powerful middlemen known as pharmacy benefit managers — and 30 state attorneys general and many others are joining the fray. Pharmacy benefit managers, or PBMs, are […]

U.S. Supreme Court to hear HIV case with implications for Ohio, elsewhere

BY: - July 8, 2021

It’s a practice that’s already been called anti-competitive. Now the U.S. Supreme Court could rule on whether it discriminates against the disabled. The court last week agreed to review a case focused on whether actions of insurers and pharmacy middlemen discriminate against people with HIV, the virus that causes AIDS.  The case is on appeal […]

Court ruling could spotlight questionable practices by health care companies

BY: - July 6, 2021

When you’re emailing about medical billing, it’s probably best not to write about using “dummy codes” to “bury” administrative fees. But two huge health care companies did just that between 2012 and 2016, and now it’s an issue that is poised to get new attention. Ohio is already suing one of the companies, claiming improper […]