Pharmacy Benefit Management

From Drug Benefit News - Cigna Corp. recently unveiled a partnership with CVS Health through which the health plan says it hopes to provide more value to its self-funded employer-sponsored health plans and their members. Industry experts maintain that the program likely will be of interest to employers, as it should help their members take more control of their own health care. Cigna Health Works “aligns Cigna-administered health benefits with CVS Pharmacy and CVS MinuteClinic retail health care services,” say the companies. Read more

From Drug Benefit News - Without a year-round audit readiness approach, SCAN Health Plan would not have been able to successfully negotiate the complexity and challenge of a CMS pilot medication therapy management (MTM) enforcement audit, according to Crystal Chang, manager of clinical pharmacy services at SCAN. Because SCAN, the Long Beach, Calif.-based managed care plan, was the first plan to be audited in the 2016 pilot, “it was a learning experience” for both CMS and… Read more

Pharmacy Benefit Management Blog

By Angela Maas - May 18, 2017
On Thursday, Vertex Pharmaceuticals Inc. said it was adding Maxor National Pharmacy Services, LLC to its specialty pharmacy network on Aug. 1. Maxor is certainly not a newcomer to the industry and brings a wealth of experience and knowledge, so the move is no surprise. But what might be a surprise...
By Lauren Flynn Kelly - April 14, 2016
In the latest squabble between drugstores and PBMs, the National Community Pharmacists Association (NCPA) on April 1 issued a letter to CMS Deputy Director Cynthia Tudor asserting that Medicare Part D plans and PBMs are not complying with a federal requirement to use drug pricing standards that “...
By Angela Maas - March 30, 2016
As high drug prices continue to make headlines and draw congressional ire, hepatitis C drugs and “Mr. Wu-Tang” Martin Shkreli seem to be getting a reprieve as focus turns to the prostate cancer drug Xtandi. On March 28, 12 members of Congress sent a letter to HHS Sec. Sylvia Burwell and Francis...

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