Reimbursement

For many years, employers, payers, and pharmacy benefit managers have been developing benefit designs to incentivize patients and providers to make cost-effective treatment decisions.

A kickback can arise if a pharmacy pays commissions to a 1099 independent contractor marketing representative who generates patients for the pharmacy who are covered by a federal health care program.

Financial distress and disruptions to work and social activities were significantly associated with depression and anxiety, as well as generally diminished psychological wellbeing.

In the years following the passage of the Affordable Care Act, early-stage cancer diagnosis increased while late-stage fell.

For hospital pharmacies, the COVID-19 pandemic sparked an abrupt and intensive reevaluation of nearly every aspect of their operations.

State Medicaid programs and other providers will need to learn more about the age distribution of autism among adults enrolled in Medicaid, in order to better serve them.

A recent study found that the US rural mortality penalty is wide and further expanding, which applies to the rural population overall, or all racial/ethnic groups combined, and for non-Hispanic whites, non-Hispanic blacks, and Hispanics individually.

Whether agreeing to an asset purchase or stock purchase in the sale of a pharmacy, the buyer must perform due diligence.

Lennartz said it’s important that pharmacists are properly reimbursed for the administration of many common immunizations, including the flu vaccine.

Evidence-based cancer regimens have been shown to result in better outcomes, including longer survival and less toxicity.

Insulin prices are 8 times higher in the United States than 32 other high-income countries combined.

Pharmacy Times® interviewed Nancy Lyons, BSPharm, MBA, CDE, vice president and chief pharmacy officer for Health Mart, and Pete Slone, senior vice president of public affairs for McKesson, on the importance of payment models that reward pharmacists’ commitment to patient services.

During American Pharmacists Month, and as the country uses all available health care resources to address COVID-19, there has never been a better or more important time to grant provider status to pharmacists.

An overview of arrangements that pharmacies enter into that violate the federal anti-kickback statute.

A study published in The Lancet Public Health found that modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to more than $730 billion in health care spending in the United States in 2016.

The Provider Relief Fund, as part of the CARES Act, was an important stopgap for many health care providers across the country, but details on reporting requirements and timing have been elusive.

Technology can help revolutionize how a pharmacy manages patients, collects payments, communicates, and can improve overall efficiency.

Protections for covered entities under the 340B program will most likely be affected by decisions in the Senate.

Data standardization has been an ongoing problem in the specialty pharmacy field, affecting both patients and providers when approaching treatments.

During the COVID-19 pandemic, many families and individuals have not been able to pay their out-of-pocket costs or do not have enough money saved to pay their deductibles.

Researchers found that although the number of Medicare beneficiaries increased between 2014 and 2018, total costs decreased.

The terms of participation in the phase 2 round of the Provider Relief Fund created an unintended exclusion for pharmacies that primarily serve Medicaid/Children’s Health Insurance Program patients.

Racial and economic disparities are especially pronounced among patients on Medicare, study shows.

The goals of specialty pharmacy programs are to reduce or delay progression of the disease, improve patient outcomes, enhance patients’ quality of life, keep patients in the workforce longer, and decrease total health care costs.

With election season intensifying, 35% of voters said drug pricing is among the most important issues influencing their vote in November.

More than 40 million unemployment claims have been filed over the course of the COVID-19 pandemic.

NACDS states that although prescription drug discount cards were put in place to reduce out-of-pocket costs, states have been using the data in a manner inconsistent with federal law and policy.

National Association of Chain Drug Stores joins with 20 other groups in asking Congress to take action that includes designating pharmacists as providers under Medicare.

A new study found that Medicare Part D prescription drug insurance plans largely favor generic drugs over brand-name counterparts, despite previous reports to the contrary.

Vizient report shows that the COVID-19 pandemic resulted in a $200 million increase in the top 10 COVID-related drugs, as well as a decrease in vaccinations between March and April.