prescription drugs
Centene agrees to pay Massachusetts $14 million over Medicaid prescription claims
Massachusetts has become the latest state to settle with health insurance giant Centene Corp. over allegations that it overbilled the state’s Medicaid program for pharmacy services. St. Louis-based Centene, the nation’s largest Medicaid managed-care insurer, will pay $14.2 million, according to Massachusetts Attorney General Maura Healey. Before the Massachusetts agreement, Centene had settled with Ohio, […]
As new Medicaid prescription program nears, some Ohio pharmacists are worried
Ohio’s community pharmacists are still worried that the state Medicaid program might drive them out of business — and deprive some communities of access to medicine. After years of complaints about under-payment and possible profiteering off of prescription drugs, the legislature in 2019 directed the Department of Medicaid to undertake a bold reform. Instead of […]
How Medicare prescription drug coverage would change under U.S. Senate Democrats’ bill
WASHINGTON — A major spending bill from U.S. Senate Democrats would allow Medicare for the first time in its history to begin negotiating the prices of certain high-priced prescription drugs — a proposal that’s been around for years but has never come so close to the finish line. Under the legislation, Medicare would start negotiating the […]
Medicare prescription drug negotiation plan advanced by U.S. Senate Democrats
WASHINGTON — U.S. Senate Democrats have reached a tentative agreement to negotiate the cost of prescription drugs in the Medicare program, the first step in passing a long-stalled package that’s expected to include tax and climate change provisions as well. The deal, brokered between Senate Majority Leader Chuck Schumer and West Virginia Democrat Joe Manchin […]
How House Democrats would expand Medicare and Medicaid and lower prescription drug costs
WASHINGTON — New Medicare benefits for older Americans, like dental care. An expansion of eligibility for Medicaid for low-income people in Republican-controlled states that have declined to take that step. And potentially an historic effort to rein in prescription drug prices — if congressional Democrats can work through objections from moderates in their party. The massive […]
Additional corporations reported to be facing states’ drug-middleman probes
More states are investigating more companies regarding their conduct in the multi-billion dollar business of managing drug transactions, the Wall Street Journal reported Tuesday. The reporting comes after the Capital Journal in April reported that attorneys general in Ohio, Kansas, Mississippi and Arkansas were investigating health care giant Centene. Ohio Attorney General Dave Yost has […]
Drugmaker on rising prices: Don’t look at us
A subsidiary of a leading U.S. drugmaker is reporting that the net cost of its products has been falling. If that’s true, it would appear that drug middlemen and insurers are driving increases in the overall cost of medicine and in consumers’ out-of-pocket costs at the counter. The report, by Johnson & Johnson subsidiary Janssen […]
Ohio suit against health care giant is sealed. Here’s why
Ohio Attorney General Dave Yost last week filed suit against the largest Medicaid managed-care provider in the United States. The suit appears to accuse St. Louis-based Centene of improper billing, misrepresentation of its costs and other offenses. But it’s impossible to know for sure because the case was filed under seal. For the most part, […]
Will state Medicaid reforms prove we were getting a bad deal?
The Ohio Department of Medicaid in January implemented a massive overhaul to the way it administers prescription drug benefits to more than a quarter of all Ohioans. Now, the department is hiring its own middleman to handle the transactions. The department expects to save $128 million during the fiscal year starting July 1 and $184 […]
U.S. Supreme Court deals big blow to pharmacy middlemen
The U.S. Supreme Court on Thursday ruled 8-0 that states have broad powers to regulate powerful pharmacy middlemen without being preempted by federal law. The case was brought by the $400-billion-a-year industry, known as “pharmacy benefit managers,” against the state of Arkansas over a 2015 law that set a minimum, market-based rate the middlemen had […]
Supreme Court hears arguments over states’ ability to regulate drug costs
How much leeway states have to control drug middlemen was at the heart of arguments Tuesday before the U.S. Supreme Court.
Big fight over drug pricing heads to the Supreme Court
A years-long fight over whether states have the authority to regulate important aspects of drug pricing will be argued before the U.S. Supreme Court Tuesday morning.