Content about Healthcare reform in the United States

October 4, 2011

The National Community Pharmacists Association is recommending several ways for reducing Medicare Part D fraud, waste and abuse to the Senate Homeland Security and Government Affairs subcommittee, the group said Tuesday.

ALEXANDRIA, Va. — The National Community Pharmacists Association is recommending several ways for reducing Medicare Part D fraud, waste and abuse to the Senate Homeland Security and Government Affairs subcommittee, the group said Tuesday.

October 3, 2011

Coventry Health Care on Saturday announced that it has partnered with Walgreens, Walmart and Target for 2012 to offer a Medicare prescription drug plan known as First Health Value Plus.

BETHESDA, Md. — Coventry Health Care on Saturday announced that it has partnered with Walgreens, Walmart and Target for 2012 to offer a Medicare prescription drug plan known as First Health Value Plus.

As Coventry’s newest Medicare Prescription Drug Plan, First Health Value Plus is the lowest premium, zero-dollar deductible Part D plan in the United States, the company stated.

October 3, 2011

CVS/pharmacy has teamed up with Aetna to offer Medicare beneficiaries a co-branded prescription drug plan.

HARTFORD, Conn. — CVS/pharmacy has teamed up with Aetna to offer Medicare beneficiaries a co-branded prescription drug plan.

The companies said the new Aetna CVS/pharmacy Prescription Drug Plan will be made available to beneficiaries in 43 states and Washington, D.C. The plan offers a $26 monthly plan premium and has no deductible for generic drugs. In addition, members will have the following benefits when they fill their prescriptions at a CVS/pharmacy (compared with a nonpreferred network pharmacy):

October 3, 2011

Humana will offer Medicare Part D beneficiaries a prescription drug plan co-branded with Wal-Mart Stores, the two companies said Monday.

LOUISVILLE, Ky. — Humana will offer Medicare Part D beneficiaries a prescription drug plan co-branded with Wal-Mart Stores, the two companies said Monday.

The plan, originally launched in 2010, will be launched again for 2012 and will include savings on monthly plan premiums, prescription drug copayments and cost-shares for beneficiaries.

September 22, 2011

A congressman from Texas is urging the Department of Health and Human Services to reject an attempt by the Texas state government to move millions of Medicaid prescription drug beneficiaries into managed care plans.

WASHINGTON — A congressman from Texas is urging the Department of Health and Human Services to reject an attempt by the Texas state government to move millions of Medicaid prescription drug beneficiaries into managed care plans.

Democratic Rep. Lloyd Doggett, head of the Texas Democratic Congressional Delegation, said the move would harm small pharmacies that cater to Medicaid beneficiaries and leave many patients without access to pharmacy services by reducing pharmacy dispensing fees to far below the average pharmacy's cost of dispensing each prescription.

September 15, 2011

The use of over-the-counter medicines as a cost savings tool is catching on, of all places, at the Centers for Medicare and Medicaid.

REDWOOD CITY, Calif. — The use of over-the-counter medicines as a cost savings tool is catching on, of all places, at the Centers for Medicare and Medicaid. Certain plans under Medicare are utilizing a new prepaid card of sorts to allow members to pay for their OTC medicines. Medicaid administrators, meanwhile, are employing that same card to incentivize healthier behavior among its members.

September 15, 2011

A value-based benefits project saved a group of employers in Kansas City, Mo., nearly $11 million in direct healthcare costs.

KANSAS CITY, Mo. — A value-based benefits project saved a group of employers in Kansas City, Mo., nearly $11 million in direct healthcare costs.

The Kansas City Collaborative, or KC2, launched a project focused on giving employees and their dependents access to better health information, reducing barriers to preventive care, engaging them in reducing health risks and accessing earlier treatment of chronic disease. Led by the Mid-America Coalition on Health Care, the project included 15 local employers and about 400,000 area employees and their dependents.

September 13, 2011

Walgreens, the Department of Health and Human Services, the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services on Tuesday announced the kick-off of the Million Hearts Initiative, a public and private sector initiative to help prevent 1 million heart attacks and strokes over five years.

DEERFIELD, Ill. — Walgreens, the Department of Health and Human Services, the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services on Tuesday announced the kick-off of the Million Hearts Initiative, a public and private sector initiative to help prevent 1 million heart attacks and strokes over five years.

September 12, 2011

While it has been a boon to elderly Americans, Medicare Part D includes a complicating factor that has proven to be a headache.


While it has been a boon to elderly Americans, Medicare Part D includes a complicating factor that has proven to be a headache.


Despite its seemingly charming name, the doughnut hole has proven to be a headache for many seniors. Also known as the Medicare Part D coverage gap, the doughnut hole is when drug costs reach a point when the patient becomes responsible for the entire cost, and Medicare doesn’t pay for them again until they reach the catastrophic-coverage threshold. The hole and threshold change from year to year.


September 9, 2011

The National Association of Chain Drug Stores is calling on Congress to scrutinize the proposed merger of pharmacy benefit managers Express Scripts and Medco and, in a letter submitted Friday to the House of Representatives Ways and Means Subcommittee on Health, outlined the “problems” it believes would result from the mega-merger.

ALEXANDRIA, Va. — The National Association of Chain Drug Stores is calling on Congress to scrutinize the proposed merger of pharmacy benefit managers Express Scripts and Medco and, in a letter submitted Friday to the House of Representatives Ways and Means Subcommittee on Health, outlined the “problems” it believes would result from the mega-merger.

The House panel held a hearing Friday titled “Health Care Industry Consolidation.”

August 30, 2011

The National Community Pharmacists Association on Monday urged the federal government to reject Florida’s request to extend and expand its Medicaid managed care pilot program statewide from five to 67 counties.

ALEXANDRIA, Va. — The National Community Pharmacists Association on Monday urged the federal government to reject Florida’s request to extend and expand its Medicaid managed care pilot program statewide from five to 67 counties.

August 22, 2011

The National Community Pharmacists Association last week delivered a letter to the Illinois Joint Committee on Administrative Rules opposing an Illinois Department of Healthcare and Family Services proposal to sharply decrease Medicaid reimbursements and “slow-walk” reimbursement payments.

ALEXANDRIA, Va. — The National Community Pharmacists Association last week delivered a letter to the Illinois Joint Committee on Administrative Rules opposing an Illinois Department of Healthcare and Family Services proposal to sharply decrease Medicaid reimbursements and “slow-walk” reimbursement payments.

The action could force more than 700 independent community pharmacies to shutter their doors, the NCPA stated.

August 22, 2011

The other side of the retail clinic phenomenon is urgent care, which also is growing as the need for alternative sites of care becomes more apparent, and providers look to fill the gaps in health care. This is why it is important to note the news of Solantic’s expansion plans.

WHAT IT MEANS AND WHY IT'S IMPORTANT — The other side of the retail clinic phenomenon is urgent care, which also is growing as the need for alternative sites of care becomes more apparent, and providers look to fill the gaps in health care. This is why it is important to note the news of Solantic’s expansion plans.

(THE NEWS: Solantic announces statewide hiring. For the full story, click here)

August 17, 2011

Medicare Part D beneficiaries who enter the "doughnut hole," where they have to pay 100% of previously subsidized prescription costs, are twice as likely to discontinue their medications as they are to switch to more affordable or generic medications, according to a new study conducted by researchers from Harvard University, Brigham and Women's Hospital and CVS Caremark.

WOONSOCKET, R.I. — Medicare Part D beneficiaries who enter the "doughnut hole," where they have to pay 100% of previously subsidized prescription costs, are twice as likely to discontinue their medications as they are to switch to more affordable or generic medications, according to a new study conducted by researchers from Harvard University, Brigham and Women's Hospital and CVS Caremark.

August 15, 2011

It's a strategic next step in retail pharmacy, a setting that has fast evolved as the intrinsic destination for all health-related matters: health advice, self-care solutions, medication therapy management, compliance programs, acute-care services and now, if the reports turn out to be accurate, branded healthcare insurance.

WHAT IT MEANS AND WHY IT'S IMPORTANT — It's a strategic next step in retail pharmacy, a setting that has fast evolved as the intrinsic destination for all health-related matters: health advice, self-care solutions, medication therapy management, compliance programs, acute-care services and now, if the reports turn out to be accurate, branded healthcare insurance. And by the time this offering would be available in 2014, the need for affordable healthcare insurance may go well beyond the 48.6 million uninsured that exist today.

August 11, 2011

Medicare Part D beneficiaries showed better adherence to their oral diabetes drugs when receiving them by mail order, according to a new study.

IRVINE, Calif. — Medicare Part D beneficiaries showed better adherence to their oral diabetes drugs when receiving them by mail order, according to a new study.

The study, conducted on behalf of Prescription Solutions by OptumRx, the pharmacy benefit management arm of health services company Optum, and published in the Journal of Medical Economics, found that patients using mail-order pharmacy showed adherence rates of 49.7%, compared with 42.8% of those who went to retail pharmacies.

August 9, 2011

Walgreens is planning to sell health insurance as soon as this fall, CNNMoney reported Tuesday morning.

NEW YORK — Walgreens is planning to sell health insurance as soon as this fall, CNNMoney reported Tuesday morning.

Walgreens declined to comment on the matter, according to the report.

The Chicago-based pharmacy-and-more operator would sell health insurance products with different price ranges and coverage levels across its network nationwide through a private health insurance exchange, CNNMoney reported, citing people familiar with the plan.

August 5, 2011

Medicare Part D prescription drug plan premiums will cost beneficiaries roughly $30 in 2012, according to data from the Centers for Medicare and Medicaid Services.

WASHINGTON — Medicare Part D prescription drug plan premiums will cost beneficiaries roughly $30 in 2012, according to data from the Centers for Medicare and Medicaid Services.

The Pharmaceutical Care Management Association, a trade group representing pharmacy benefit managers, heralded the figure, saying it confirmed the success of Medicare Part D plans in delivering savings.

August 5, 2011

Looking to challenge reimbursement rate reductions for Medicaid beneficiaries, pharmacy groups have filed a joint legal brief with the U.S. Supreme Court.

ALEXANDRIA, Va. — Looking to challenge reimbursement rate reductions for Medicaid beneficiaries, pharmacy groups have filed a joint legal brief with the U.S. Supreme Court.

The brief was filed by the American Pharmacists Association, National Association of Chain Drug Stores, National Community Pharmacists Association and the National Alliance of State Pharmacy Associations in the case of Douglas v. Independent Living Center of California.

August 4, 2011

The Alliance for Patient Care, a coalition of healthcare providers, health plans, patient advocates and others working together to protect access to care in California’s Medi-Cal (Medicaid) program, headed to Washington, D.C., to urge the Centers for Medicare and Medicaid Services and members of Congress to reject California’s proposed cut to the state’s Medi-Cal program, according to a statement issued Wednesday by the National Association of Chain Drug Stores.

WASHINGTON — The Alliance for Patient Care, a coalition of healthcare providers, health plans, patient advocates and others working together to protect access to care in California’s Medi-Cal (Medicaid) program, headed to Washington, D.C., to urge the Centers for Medicare and Medicaid Services and members of Congress to reject California’s proposed cut to the state’s Medi-Cal program, according to a statement issued Wednesday by the National Association of Chain Drug Stores.

August 1, 2011

New guidelines that will ensure women receive preventive health services at no additional cost were announced Monday by the Department of Health and Human Services.

WASHINGTON — New guidelines that will ensure women receive preventive health services at no additional cost were announced Monday by the Department of Health and Human Services.

Developed by the independent Institute of Medicine, the new guidelines require new health insurance plans to cover women’s preventive services, such as well-woman visits, breast-feeding support, domestic violence screening and contraception without charging a co-payment, co-insurance or a deductible.

July 29, 2011

Pharmacy benefit management tools helped slow prescription drug spending growth from 5.3% in 2009 to 3.5% in 2010, according to a new study by the Centers for Medicare and Medicaid Services.

WASHINGTON — Pharmacy benefit management tools helped slow prescription drug spending growth from 5.3% in 2009 to 3.5% in 2010, according to a new study by the Centers for Medicare and Medicaid Services.

One PBM tool that helped was tiered co-pays that shifted medication use toward lower-cost generic drugs.

July 27, 2011

The Patient Protection and Affordable Care Act is producing savings for state Medicaid programs that take advantage of a provision equalizing drug rebates between managed care and fee-for-service programs, according to a fact sheet released Tuesday by the Association for Community Affiliated Plans.

WASHINGTON — The Patient Protection and Affordable Care Act is producing savings for state Medicaid programs that take advantage of a provision equalizing drug rebates between managed care and fee-for-service programs, according to a fact sheet released Tuesday by the Association for Community Affiliated Plans.

July 22, 2011

The National Association of Chain Drug Stores announced Thursday that it has submitted comments to the U.S. Senate Special Committee on Aging outlining the value of the pharmacist-patient interaction in helping improve health and reduce costs in the Medicare program, and urged the committee to support the Medication Therapy Management Empowerment Act of 2011, which seeks to increase access to pharmacy services for Medicare beneficiaries.

ALEXANDRIA, Va. — The National Association of Chain Drug Stores announced Thursday that it has submitted comments to the U.S. Senate Special Committee on Aging outlining the value of the pharmacist-patient interaction in helping improve health and reduce costs in the Medicare program, and urged the committee to support the Medication Therapy Management Empowerment Act of 2011, which seeks to increase access to pharmacy services for Medicare beneficiaries.

July 22, 2011

Bipartisan legislation recently introduced to the Senate has received endorsement from a group representing the retail pharmacy industry.

ALEXANDRIA, Va. — Bipartisan legislation recently introduced to the Senate has received endorsement from a group representing the retail pharmacy industry.