PHARMACIST STEVE

Medicare Advantage insurers ranked by prior auth denial overturn rates https://www.beckerspayer.com/payer/medicare-advantage-insurers-ranked-by-prior-auth-denial-overturn-rates.html Centene is the most likely to overturn a prior authorization denial decision when appealed, while Humana is the least likely, according to a KFF analysis. Medicare Advantage insurers denied 7.4% of prior authorization requests in 2022, up from 5.8% in 2021. Among those denials, […]

Filed under: General Problems | Leave a Comment »

In 2022 the SCOTUS told the EPA & ATF that they did not have the statutory authority to create new interpretations of the laws they were in charge of enforcing.  The SCOTUS did not tell the DEA that they did not have the authority to create new interpretations of the Control Substance Act in 2022. […]

Filed under: General Problems | Leave a Comment »

Filed under: General Problems | 1 Comment »

Is this a good example of why our judicial system should not be in charge of dealing with people and addictions? The recommendation to this person is that he should get off his medication and use ABSTINENCE to maintain his sobriety. Does this suggest that those within/around our judicial system consider addictions a CHOICE?

Filed under: General Problems | Leave a Comment »

Medicare Advantage woes pose growing threat to hospitals: S&P https://www.beckershospitalreview.com/finance/medicare-advantage-woes-pose-growing-threat-to-hospitals.html As Medicare Advantage continues to grow and health insurers prioritize their margins in the segment, hospitals are the most vulnerable healthcare provider to rising administrative and financial MA burdens, according to a new report from S&P Global. The Aug. 15 report shared with Becker’s highlights […]

Filed under: General Problems | 2 Comments »

Heat spells trouble for mail-order medications https://www.beckershospitalreview.com/pharmacy/heat-spells-trouble-for-mail-order-medications.html Mail-order pharmacies run well-coordinated supply chain operations to ensure medications are safely delivered to patients’ doorsteps, but extreme temperatures are complicating the process, The New York Times reported Aug. 13. Pharmacists and physicians told the Times that high temperatures inside delivery trucks could cause certain medications such as […]

Filed under: General Problems | 1 Comment »

Collectively we are in the process of 10,000+ pharmacies have or will be closing.  Many of the major mail-order pharmacies are owned by the same major insurance/pbm companies, and they will be pushing and creating financial incentives for people to use them currently, they are pushing back on state pharmacy boards that are trying to […]

Filed under: General Problems | 1 Comment »

Where VP picks stand on pharmaceutical costs https://www.beckershospitalreview.com/pharmacy/where-vp-picks-stand-on-pharmaceutical-costs.html JD Vance and Tim Walz, the Republican and Democratic candidates for vice president, respectively, have both voiced support for aspects of the Inflation Reduction Act, a landmark law that aims to lower prescription drug prices.  Here are each candidate’s records on rising pharmaceutical costs, which are projected […]

Filed under: General Problems | Leave a Comment »

The ideal time for a pt to get their flu shot is the last 2 weeks of Sept thru the first 2 weeks of Oct. Getting your flu shot during this time frame will help assure that the pt’s “blood titer” is as high as possible during what should be the peak flu season. Pts […]

Filed under: General Problems | Leave a Comment »

We had our independent pharmacy for 20 yrs, we were not in a rural area but a small city/county seat with ~ pop of 30,000.  One very memorial day – at least for me – I had a regular pt & wife come in. He wanted his blood pressure taken.  That was before “free-standing blood […]

Filed under: General Problems | Leave a Comment »