Content about Healthcare reform in the United States

BALTIMORE — The Centers for Medicare and Medicaid Services earlier this month released a memo to all Part D sponsors, warning them that the agency has "observed an increase in beneficiary complaints related to the transfer of prescriptions from retail pharmacies to either mail-order or specialty pharmacy without their explicit consent."

I am the 99%. And thank God for that. But it’s not what you think. This isn’t about radical politics and class warfare. I’m not looking to tax the 1%. I just want them to take better care of themselves. And I’m definitely not the only one. More and more, payers, insurers and big government are all looking at ways to get this group to live a little healthier. 


ALEXANDRIA, Va. — The National Association of Chain Drug Stores announced on Wednesday that it has submitted comments to the U.S. House Ways and Means Subcommittee on Health urging that retail pharmacies remain exempt from the Medicare durable medical equipment competitive bidding program. The subcommittee held a hearing regarding the program on Wednesday.

WOONSOCKET, R.I. — CVS Caremark announced on Wednesday that it is supporting Million Hearts during National High Blood Pressure Education Month in May through a number of patient-focused initiatives.

Launched by the Department of Health and Human Services and led by the Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Services, Million Hearts is a national initiative to prevent 1 million heart attacks and strokes in the United States over the next five years.

WHAT IT MEANS AND WHY IT'S IMPORTANT — The news that Take Care Clinics now are offering wellness services for Medicare enrollees clearly demonstrates that there’s an opportunity for retail clinics to fill gaps in care, and promote wellness and better patient outcomes.

(THE NEWS: Take Care Clinics offering Medicare wellness visits. For the full story, click here.)

How do you squeeze water from a stone? That seems to be the goal of the U.S. Centers for Medicare and Medicaid Services in its long quest to cut prescription reimbursements for Medicaid patients by setting new, tighter payment caps for the community pharmacies that dispense those medicines.

LEESBURG, Va. — A group that claims a membership of more than 20,000 pharmacies nationwide has appointed a new member to its leadership team.

RxAlly announced that it had hired John Miall as national practice leader for integrated care initiatives. Miall will work with payers, government agencies and others on commercial, self-funded, Medicaid and Medicare programs through medication therapy management and other pharmacist-based care models.

WASHINGTON — The Supreme Court on Tuesday morning heard arguments on whether the individual mandate portion of the Patient Protection and Affordable Care Act is constitutional. The final decision, expected in June, could mean a swing between 15 million and 27 million Americans, along with their prescription and other healthcare needs, entering the insurance market in 2014, according to a recent study published by the Rand Corp.

WASHINGTON — Industry-supported legislation designed to improve pharmacy benefits manager standards under the Medicare prescription drug program — standards that will further provide fair audits of and payments to pharmacies — was presented before the House of Representatives on Tuesday.

WASHINGTON — The National Community Pharmacists Association last week sent a follow-up letter to the Centers for Medicare and Medicaid Services asking the agency to revisit a decision last month that effectively requires some pharmacies to pay duplicative fee-for-service Medicare enrollment/revalidation fees, according to the association.

ALEXANDRIA, Va. — The Supreme Court has sent a lawsuit challenging cuts to California's Medicaid program back to a lower court.

The high court ruled 5-4 in the case of Douglas v. Independent Living Center of Southern California that healthcare providers could challenge Medicaid reimbursement cuts under the U.S. Constitution's supremacy clause. The decision returns the case to the Ninth Circuit Court of Appeals, which had originally ruled that the providers had standing to sue.

WHAT IT MEANS AND WHY IT'S IMPORTANT — The call to Congress to reject budget proposals that would increase co-pays for prescription medications at community pharmacies for Tricare patients is important as the war between the pharmacy and pharmacy benefit manager lobbies heats up.