From Drug Benefit News - Consistent with other drug-trend reports in the marketplace, overall 2014 trend for clients of Catamaran Corp. was driven by a dramatic rise in specialty drug trend, thanks in large part to the entry of new hepatitis C therapies. But on the traditional side, drug costs are continuing to rise at alarming rates in the diabetes category, according to the company’s 2015 Informed Trends report. Read more
From Health Plan Week - While most health insurers have made little effort to embrace the mobile application market, a few such as UnitedHealth Group and Independence Blue Cross are actively researching ways to solve the problem of being the “last to know” in the real-time information game of mobile technology. Read more
From Inside Health Insurance Exchanges - In a bit of good news for health plans and brokers, CMS on May 5 said that HealthCare.gov’s Direct Enrollment (DE) function will be made available outside of the official open-enrollment period, HEX has learned. The technology — which connects systems used by brokers and carriers directly to HealthCare.gov to enable subsidy calculations and enrollment — previously wasn’t available for special enrollment periods (SEPs). In a conference call, CMS said it… Read more
From Medicare Advantage News - Now that almost all of the CMS-backed initiatives for Medicare-Medicaid dual eligibles are up and running, it has become clear that reaching many of the ambitious goals in these programs will be nearly impossible over the short term. There have been and will continue to be improvements in integrated care for duals as a result of the demo, plan executives tell MAN, but such aspects as cost savings, good outcomes… Read more
From Drug Benefit News - Nearly a year after the last of the valid patents on Teva Pharmaceutical Industries Ltd.’s multiple sclerosis drug Copaxone (glatiramer acetate) expired, the FDA on April 16 cleared Sandoz Inc. and Momenta Pharmaceuticals, Inc. to market Glatopa, the first substitutable generic version of the daily injectable therapy. While entry of the generic has the potential to significantly lower costs in the multiple sclerosis category, there are several uncertainties that may… Read more
From Report on Medicare Compliance - Nine Florida hospitals are on the hook for false claims allegedly submitted by two independent ambulance companies because they were based on questionable certifications of medical necessity from the hospitals. Although they didn’t bill for the ambulance services, four hospitals owned by Baptist Health System will pay $2.88 million, four hospitals affiliated with HCA will pay $2.4 million, and Shands Jacksonville Medical Center will pay $1 million to resolve allegations… Read more
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