UnitedHealth
11th state settles with Medicaid contractor over conduct first uncovered in Ohio
Centene, the largest Medicaid contractor in the United States, has settled with an 11th state over conduct that was initially detected in Ohio. On Aug. 24, a deal was announced between Washington Attorney General Bob Ferguson and St. Louis-based Centene to settle claims that Centene’s pharmacy benefit manager had overbilled the state’s Medicaid system, Reuters […]
Basketball billionaire enters the no-insurance, no-middleman drug business
Mark Cuban, owner of the Dallas Mavericks, is getting into a business pioneered by independent pharmacists in Ohio and elsewhere. The idea is to radically reduce consumer costs for common generic drugs by cutting out insurance companies and the middlemen they hire to handle transactions with manufacturers and pharmacies. On Jan. 19, the Mark Cuban […]
Insurers slam critical drug-pricing research but can’t vouch for their own
A spokeswoman for a major health-insurance industry group on Wednesday questioned research cited in a story published Tuesday in the Capital Journal. In doing so, she cited a bit of purported research that she couldn’t vouch for herself. The story was about research showing that insurers working with Medicare are supposed to be lowering care […]
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 […]
Court ruling could spotlight questionable practices by health care companies
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 […]
Ohio suits against drug middlemen headed for the long haul
Ohio has been one of the most active states litigating against drug middlemen, whom Attorney General Dave Yost accuses of bilking state agencies out of tens of millions of dollars. Other states also have been active in court against the healthcare giants. Notably, Arkansas last year squared off at the U.S. Supreme Court against the […]
Federal regulator’s oversight of the drug supply chain blasted — by one of the regulators
One of two federal agencies tasked with policing anticompetitive behavior among corporations last week said it has a lot more work to do when it comes to the prescription-drug supply chain. One of the members of the Federal Trade Commission went even further. He suggested the agency has abdicated its responsibility as drug prices have […]
Antitrust concerns are increasing on Capitol Hill. Advocates say they should extend to drug pricing
Antitrust concerns are increasing on Capitol Hill. Advocates say they should extend to drug pricing.
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 […]
Federal probe of drug middlemen urged
After years of accusations in Ohio and elsewhere, a bipartisan group in the U.S. Senate wants federal regulators to investigate whether drug middlemen and their parent companies are rigging the system to raise prices and pad their pockets. Sens. Chuck Grassley, R-Iowa, and Maria Cantwell, D-Wash., last month filed legislation that would require the federal […]