From The AIS Report on Blue Cross and Blue Shield Plans - Almost one year into its oncology pathways initiative, Anthem, Inc. continues to expand the program aimed at rewarding oncologists for providing high-quality cancer care. Through the Anthem Cancer Care Quality Program — which is implemented through Anthem subsidiary AIM Specialty Health — oncologists in Anthem’s network can enroll patients in the program, select a treatment regimen that is on pathway and then file a claim to receive $350 per month for monthly management. They also receive a one-time $350 payment when initiating therapy for planning the treatment and coordinating care. And when providers select on-pathway regimens that need prior authorization, approval… Read more
From Health Plan Week - State legislatures are stepping into the ring in the fight over the rising cost of pharmacy drugs, introducing bills designed to limit the costs to consumers through a myriad of methods, including improved price transparency and capping member copays. Measures proposing those regulations, for instance, are currently in play in the Oregon House of Representatives, sparking an intensive debate among advocacy groups, health insurers and pharmaceutical companies. Read more
From Health Plan Week - UnitedHealth Group’s $12.8 billion play for the fourth-largest PBM Catamaran has raised concerns over client retention as market specialists question if other health plans — like Cigna Corp. — will reconsider their arrangements with the standalone PBM Catamaran now that it appears it will become part of UnitedHealth’s OptumRx. Read more
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