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Industry News

Aug 17, 2015

The national association representing pharmacy benefit managers is suing the state of Arkansas over a first-of-its kind law governing payments to pharmacies for generic drugs.

The law requires benefit managers to pay pharmacies the amounts those pharmacies spent to buy generic drugs from wholesalers, according to invoices. Before the law's passage, pharmacies had complained that benefit managers often paid them less for generics than what it actually cost the pharmacies to buy them...

Aug 17, 2015

A selection of opinions on health care from around the country.

The Washington Post: A Misguided Lawsuit
Amazingly, yet another lawsuit challenging a significant provision of the Affordable Care Act remains pending in court. This time, however, what is at stake is not a disagreement about Obamacare, but a question about the role of the judiciary: Should the House be able to bring a lawsuit simply because it disagrees with how the president is interpreting the statutes that...

Aug 17, 2015

Meanwhile, NBC examines the similarities between the policy positions of Hillary Clinton and President Barack Obama.

Politico: Trump Hails Women's Health Issues, Details Abortion Exemptions
Donald Trump, calling women’s health issues “very important,” is making it clear he now supports a woman’s right to chose an abortion in the case of rape, incest or if her life is at risk. (Shutt, 8/16)

Politico: Carly Fiorina: Vaccinations Should Be Left Up To Parents...

Aug 17, 2015

Elsewhere, thousands of Boeing employees must decide whether to opt for a new health insurance option with provider Mercy Health that offers lower premiums and no copays but restricts patients to network doctors.

The Wall Street Journal: Steelworkers To Rally For Wage, Health-Benefit Pacts
These labor talks are the first in a generation to be held during a down market. During the past two negotiating sessions—in 2008 and 2012—prices were strong. Workers had bargaining...

Aug 16, 2015

The digital divide between small, rural hospitals and larger, urban hospitals is closing. And that success is due, in part, to the federal electronic health-record incentive program.

At least 94% of small and rural hospitals, according to the latest CMS data, now has an EHR system, or has contracted to buy one, with top-level functionality such as computerized physician-order entry to complete orders, clinical decision support and interoperability, according to the latest CMS data.....

Aug 16, 2015
New York Gov. Andrew Cuomo has vetoed legislation to give doctors the final say on which prescription drugs to prescribe for their patients in Medicaid's managed care programs.

Sponsors say doctors in Medicaid's fee-for-service program have that authority, and the legislation was meant to continue that in the government-funded health care program's increasingly used managed care programs.

In his veto message, Cuomo says signing it into law would have raised costs beyond budgeted...

Aug 07, 2015

Another federal appeals court Friday ruled against Catholic church-affiliated groups—including hospitals—that oppose being required to provide contraceptive care to employees through a third party.

The 2nd U.S. Circuit Court of Appeals overturned a Brooklyn judge's ruling affecting over 25,000 employees at two high schools, six hospitals, three nursing homes and several not-for-profits.

The appeals court in Manhattan said an Affordable Care Act provision that lets religion-...

Aug 07, 2015

A selection of opinions on health care from around the country.

The Wall Street Journal: The Republican Rumble
The field may be too large to fit in a single stage, but Republican voters should be pleased that they have several plausible would-be Presidents to choose from. ... [Donald Trump's] appeal is attitude, not substance. You know, the art of the deal. The limits of that kind of appeal came through when the businessman was asked about his past support for “single-...

Aug 07, 2015

Also in the news, the CVS decision to stop covering Viagra for many of its drug plan members is the latest example of how some health-care managers are using muscle to control rising drug costs.

Reuters: Hospitals Seek Justice Department Probe Of Anthem-Cigna Deal
Hospitals are urging antitrust regulators to consider whether health insurer Anthem Inc.’s planned acquisition of rival Cigna Corp. would boost health care costs. In a letter to the U.S. Department of Justice,...

Aug 07, 2015

In June, Blue Cross and Blue Shield of North Carolina said it was seeking to raise rates by almost 26 percent but now says even that jump is not sufficient to cover the company's costs. Elsewhere, Delaware will not move forward with plans to build its own insurance exchange while in Washington, the head of that state's exchange is stepping down.

The Associated Press: Blue Cross Raises Rate Hike Sought On Affordable Care Plans
North Carolina's largest health insurer says...