Employee-Paid

The new state regulations are aimed at increased transparency to consumers and employers, as well as rooting out spread-pricing, which enables PBMs to charge pharmacists higher prices than they pay to manufacturers.

Patients have been reporting mysterious claims to Medicare for months of catheters they never ordered or received, which led to a massive spike in billing the accounts of more than 450,000 Medicare beneficiaries in 2023.

Artificial intelligence could do more harm than good without careful oversight, according to the Senate Finance Committee, which met to address how to prevent algorithmic bias and unfair care denials by health plans.

The CEOs of Merck, Bristol Myers Squibb and Johnson & Johnson faced a barrage of questions on Capitol Hill from Sen. Bernie Sanders (I-VT) and other members of the Health, Education, Labor and Pensions committee.

Last year, lawmakers in 29 states considered some 90 bills that would regulate quicker response times from insurers, according to the American Medical Association, with victories in New Jersey and Washington, D.C.

The state plans to invest $6.5 million in funds from the 2021 American Rescue Plan Act toward a partnership with nonprofit RIP Medical Debt, which buys bundled medical debt portfolios from providers.

The Delinking Revenue from Unfair Gouging (DRUG) Act would require pharmacy benefit managers that contract with a carrier offering federal health benefits plans to "de-link" the fees they charge insurers from the price of drugs.  

Only about 3 in 10 believe the quality of care and services they receive reflect their costs.