Maybe this is why they are now calling it Medicare-C – there is little ADVANTAGE!

CMS proposes additional prior auth reforms for Medicare Advantage plans https://www.cmadocs.org/newsroom/news/view/ArticleId/50770/CMS-proposes-additional-prior-auth-reforms-for-Medicare-Advantage-plans CMS has proposed new regulations aimed at reducing the inappropriate use of prior authorization in Medicare Advantage programs. The Centers for Medicare & Medicaid Services (CMS) recently proposed regulations that would establish additional guardrails on Medicare Advantage plans’ prior authorization practices — including the […]

Pain Refugees: Collateral Damage of the War on Drugs

https://www.cato.org/events/pain-refugees-collateral-damage-war-drugs For much of the 21st century, public health officials and policymakers have blamed doctors for overprescribing opioids and causing the overdose crisis. In response, the Centers for Disease Control and Prevention issued pain management guidelines aimed at reducing opioid prescriptions. Most states have codified them into law. Federal and local drug task forces have […]

HEY BIDEN !!

Pharmacies sue GoodRx, accusing the company of conspiring with PBMs

Pharmacies sue GoodRx, accusing the company of conspiring with PBMs https://www.healthcare-brew.com/stories/2024/11/19/pharmacies-sue-goodrx-accusing-company-conspiring-pbms It’s not all good news for GoodRx. The drug discount company is facing at least three separate class-action lawsuits from independent pharmacies accusing it of “conspiring” with pharmacy benefit managers (PBMs) to fix reimbursement rates in a way that boosts the PBMs’ profits. Also […]

Chronic Pain Is Rising, and It’s Not Clear Why

Chronic Pain Is Rising, and It’s Not Clear Why More Americans are living with pain now, CDC data show https://www.medpagetoday.com/neurology/painmanagement/113149 A new CDC report indicated that the percentage of Americans with chronic pain rose considerably in recent years, and it’s not clear why. In 2023, 24.3% of U.S. adults had chronic pain lasting 3 months […]

UnitedHealth Pays Its Own Physician Groups More Than Others

Warren Blasts United Health CEO for Monopolistic Practices that Harm Patients Here is a 5 minute video of Senator Warren “ripping” the president of UHC over how they financially operate. UnitedHealth Pays Its Own Physician Groups More Than Others https://www.medpagetoday.com/special-reports/features/11314 UnitedHealth Group pays many of its physician practices “significantly more” than other groups “in the […]

C.O.L.A. Cost of living adjustment – what a joke for those on Social Security

The first SS check was issued in Jan 31, 1940 for a total sum of $22.54 and employees & employers each paid 1% of the first $3,000 a person earned. By the time I graduated college (1970) SS taxes were 4.6% of the employee’s first $7,800 and of course the employer had to pay a […]

DOJ suspends DEA searches at airports over civil rights concerns

DOJ suspends DEA searches at airports over civil rights concerns https://nypost.com/2024/11/23/us-news/doj-suspends-dea-searches-at-airports-over-civil-rights-concerns/ (The Center Square) – The U.S. Department of Justice told the Drug Enforcement Administration to suspend consensual searches at airports and other mass transit facilities after hearing about potential civil rights violations. Department of Justice Inspector General Michael Horowitz announced the suspension after hearing […]

Trump has chosen Pam Bondi as next Fed Attorney General

Here is Pam Bondi’s re-election TV video in 2014 for Florida Attorney General And the state AG of Florida is an attorney married to a DEA Agent!  

Optum audit shows possible law violation, lower payments to independent pharmacies

Optum audit shows possible law violation, lower payments to independent pharmacies https://mississippitoday.org/2024/11/07/optum-audit-shows-possible-law-violation/ The findings of a recent audit of a major company that manages prescription benefits revealed it may have violated Mississippi law. The review of Minnesota-based Optum’s business practices by the Mississippi Board of Pharmacy indicated that the company paid independent pharmacies in Mississippi […]