Independent pharmacies across the country are struggling with rising costs and declining reimbursements, forcing many to close their doors. South Carolina is experiencing the same trend, with approximately 40 independent pharmacies closing annually and only 280 remaining statewide, according to the South…
EPIC’s benefits president on pharmacy benefit manager reform, and why your health plan needs attention now The profits embedded in that spend are not flowing to care. They are captured by pharmacy benefit managers (PBMs), through spread pricing, rebates, and…
CVS is opening its first pharmacy-only stores in the Northeast as it tries to change how people access medications and in-person care. A sign above a CVS Pharmacy location. A pharmacy-only CVS location in Roxbury, MA. The Rhode Island-based company…
As prescription drug costs continue to climb, employers are demanding greater accountability from their pharmacy benefit managers, putting the market in flux. Jimmy Nesbitt is a reporter at Employee Benefit News, where he covers the evolving landscape of workplace benefits,…
What happened: GEICO alleges a Brooklyn pharmacy billed $3.7 million in no-fault claims for two pain products over 17 months through kickback-driven prescribing arrangements Who’s involved: GEICO (plaintiff) and a Brooklyn pharmacy operating as 13th Avenue Chemists, its owner, and an associated physician…
CVS Health announced on Wednesday that it plans to split into two separate companies by early 2028, separating its pharmacies from the Aetna insurance company it bought for $78 million. The move is a major dismantling of the $117 billion healthcare conglomerate CVS…
One company will house Aetna and Caremark and the other CVS’ 9,000 retail pharmacies. CVS is “effectively acknowledging that bigger isn’t always better,” one analyst said. CVS Health plans to split into two companies — one housing its insurance arm Aetna and…
For U.S. healthcare providers and pharmacy organizations, choosing the right billing company means looking beyond basic claim submission. Experience with specialty pharmacy, infusion services, eligibility, authorization, denial management, payment posting, and accounts receivable can make a significant difference in day to…
Insurance Business Insurance barriers block oral blood cancer drug access, study finds Most specialty oral blood cancer prescriptions submitted to US insurers are rejected on first attempt, and even when approved, a substantial share are never filled because the out-of-pocket…
The Illinois Retail Merchants Association and the State Department of Commerce and Economic Opportunity want the credit to pass during the fall veto session. - On Air Now Playing NPR Illinois | 91.9 UIS - On Air Now Playing NPR Illinois Classic | 91.9 HD2 - On Air…
Pharmacy insurance: claims, rules, pricing and coverage news for the trade.
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