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Managed Care February 2006	For Drugs, the VA Pays Far Less Than Medicare A recent survey indicates that prices for the top 20 drugs used by Medicare enrollees are much higher than prices negotiated by the Department of Veterans Affairs.
BusinessWeek May 10, 2004 John Carey	Drug Prices: A New Covenant? The states' growing negotiating clout with Big Pharma raises crucial questions
Managed Care July 2006	Public Payers Foot Greater Pharmacy Costs Through 2005, private health insurance had covered most of the cost of prescription drugs. That picture is changing as public payments, mostly under Part D, are projected to exceed private health insurance and out-of-pocket payments.
Managed Care November 2005 John Carroll	FTC Report Arms PBMs In Battle With Drugstores Congress passed the Medicare Modernization Act allowing pharmacy benefits managers to participate in Medicare Part D.
Managed Care September 2005	Headlines On Deadline ... WellPoint and Cigna are turning heads in the financial world... California health insurers have marked Jan. 1, 2007 on their calendars... etc.
Managed Care July 2002	CBO Weighs Effect of Growing Deficit on Fed Programs Health care programs such as Medicare and Medicaid figure to suffer, thanks to a growing federal budget deficit, according to a report by the Congressional Budget Office.
Managed Care April 2005	Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation.
Managed Care October 2005	Health Plans Pay Less When PBM Owns Mail-Order Pharmacy The ongoing debate on whether health plans pay more for drugs when using a mail-order pharmacy owned by a pharmacy benefits manager (PBM) or when the mail-order pharmacy is not owned by a PBM may be closer to resolution.
Managed Care February 2005	Medicare's Drug Coverage Seeks To Strike Compromise Health plan officials are still trying to determine just how the final rules for the new Medicare prescription drug benefit will affect them, because it appears that government officials tried their best to address the competing concerns of all players.
The Motley Fool February 24, 2009 Brian Orelli	Health Insurers Hammered. Again. Health insurers were blown away by the Centers for Medicare and Medicaid Services' announcement that it plans to raise the 2010 Medicare Advantage payment rates by only 0.5%.
Managed Care May 2006	Headlines On Deadline . . . Health plans appear to be having some trouble fulfilling a federal mandate that 80 percent of questions from Medicare beneficiaries about pharmacy coverage be answered within 30 seconds.
The Motley Fool April 7, 2009 Brian Orelli	Thanks for Nothing, CMS Insurers like Humana, Coventry Health Care, and UnitedHealth Group are going to have to raise the prices of their Medicare Advantage plans to keep their margins at a reasonable level.
The Motley Fool June 17, 2004 Seth Jayson	Big Business vs. Big Pharma An organization of human resources executives from companies that employ 12% of the private sector U.S. workforce is working to create a prescription drug "buyer's club," with the help of HR management firm Hewitt Associates.
Managed Care July 2002	Memo Clarifies CMS Guidelines on Injectables Injectable drugs should be covered by Medicare if beneficiaries administer them less than 50 percent of the time, according to a clarification on this issue by the Centers for Medicare and Medicaid services that's set to take effect Aug. 1.
Managed Care February 2007 Martin Sipkoff	As Drug Payment Model Changes, Confusion Grows Among Insurers Purchasers are hopeful that life after "average wholesale price" will be simpler, fairer, and, with luck, easier to grasp.
Pharmaceutical Executive April 1, 2007 Jill Wechsler	Washington Report: Medicaid Sets the Pace for Pharma Pricing Forget Medicare price negotiations. Pending changes in Medicaid drug-pricing formulas will put even more pressure on pharmaceutical prices.
Managed Care February 2007	Managed Care Outlook Coverage for children leads policy debate.
BusinessWeek October 3, 2005 Howard Gleckman	Medicare: Decisions, Decisions With drug and HMO plans now in the mix, seniors face a raft of complex choices.
The Motley Fool January 22, 2007 Michael P. Cecil	Will Medicare Negotiate With Drug Companies? One of the bedrock principles of our economic system is that those buying more of a product receive a discount. Wouldn't empowering Medicare to save taxpayers' money be widely embraced as a great idea? But how would pharma investors see it?
The Motley Fool July 30, 2009 Brian Orelli	A Good Business Model for Bad Times Some businesses benefit when people are hurting. It's a beautiful time to be a pharmacy benefit manager, since that business model essentially results in them making more money when their customers save money.
Pharmaceutical Executive July 1, 2005 Patrick Clinton	Playing Doctor Why Congress plans to ban erectile dysfunction drugs from Medicare and Medicaid, and why they shouldn't do it.
Pharmaceutical Executive February 1, 2007 Patrick Clinton	From the Editor: Meaningless A bill requiring the Secretary of Health and Human Services to negotiate Medicare drug prices directly with pharmaceutical manufacturers has a fatal flaw.
Pharmaceutical Executive February 1, 2014 Jill Wechsler	Drug Coverage, Costs Under Scrutiny Benefits offered by insurance plans on health exchanges and through Medicare are raising concerns about patient access to needed therapies
The Motley Fool December 11, 2007 Brian Orelli	Medicare Whacks Oncology Drugs Bad news for some pharmaceutical companies as Medicare announces it is reducing the reimbursement rate for two lymphoma drugs.
Managed Care December 2005	Pharmacy Cost Increases Below Medical for the First Time in Four Years According to a survey of 70 health care insurers, prescription costs are expected to increase at a lower rate than medical costs during the next 12 months.
Managed Care November 2007	Patient Advocates Want Part D Changes A Medicare-administered drug benefit would be more affordable and comprehensive than the current private insurance-run drug benefit, say patient advocate groups.
Managed Care July 2004 Maureen Glabman	Wish List: 10 Things You Want From Your PBM One auditor estimates that 3 percent to 10 percent of pharmacy benefit manager (PBM) claims are processed incorrectly -- always in favor of the PBM.
Managed Care August 2002 Madeleine A. Estabrook	Regulators Take More Interest In Role of PBMs in Health Care In a highly regulated industry such as health care, it is just a matter of time before every component of the industry comes under scrutiny and review. Pharmacy benefit managers are taking center stage now.
Managed Care August 2002	24 States Hope Pharmacy Plus Helps Medicaid Twenty-four states may gamble that providing a prescription drug program to low-income elderly who do not qualify for Medicaid could save them money in the long run.
Managed Care May 2002	Drug Companies Unveil Their Plan For Discount Card In the absence of any congressional action on a pharmacy benefit in Medicare, seven pharmaceutical companies have teamed up to offer a drug discount card that many call a vital first step in shoring up Medicare coverage
Financial Planning April 1, 2010 Donald Jay Korn	Medicare: Change is Coming This is a great time to get together with clients over 65 who will be affected by health care changes and go over their Medicare coverage. At the same time, you can see what other areas of financial planning are on their mind.
Inc. September 2007 Bobbie Gossage	How I Did It: Charles Hallberg, Founder and CEO, MemberHealth How Charles Hallberg turned a 13 person company into a $630 million business.
Managed Care September 2005 Martin Sipkoff	Mail Order Pharmacy Saves Money, Says PCMA, but at What Cost? The savings to consumers and employers are apparent, but are health plans left holding the bag in mail-order pharmacy?
The Motley Fool January 14, 2010 Jim Mueller	Roundtable: Which Health-Care Stocks to Buy Now Three Fool analysts give you their best ideas on where to put your money after the health-care reform bill makes it out of Congress.
Pharmaceutical Executive October 1, 2008 Jill Wechsler	Part D Under Attack Congressional leaders ready campaign to curb Medicare drug plans.
The Motley Fool August 5, 2008 Brian Orelli	Humana Not Hurting ... as Much Humana's stock jumped because the company had guided for an even bigger drop in the bottom line than it posted.
Pharmaceutical Executive November 1, 2005 Jill Wechsler	Washington Report: Out of Commission? Crawford Steps Down The clouded circumstances of the commissioner of the Food and Drug Administration may complicate the process of securing a permanent leader. Meanwhile, battles continue over hot-button issues such as the morning-after pill and the regulation of follow-on biologics.
The Motley Fool November 3, 2010 Brian Orelli	A Generic Prescription for Double-Digit Growth MedcoHealth Solutions has it.
Pharmaceutical Executive December 1, 2008 Jill Wechsler	Challenge and Challenges Expanded healthcare coverage also fits the goals of pharma manufacturers.
Managed Care May 2005	Implementing Medicare Part D Could Get Ugly This expert who hopes to help everybody adjust, nevertheless expects big headaches come Jan. 1, 2006. However, e-prescribing could make the drug plan work.
The Motley Fool May 16, 2011 Dan Caplinger	Don't Let This Kill Your Retirement Social Security and Medicare look sick. Here's how to handle it.
The Motley Fool October 5, 2010 Andrew Bond	Wal-Mart Enters the Health-Care Fray Wal-Mart and Humana's partnership will have competitors scrambling.
Managed Care June 2005	PBMs Get Thumbs up From Satisfied Customers Pharmacy benefit managers that educate physicians on the safety and efficacy of generic drugs or provide them with generic drug samples to increase the use of generics get higher satisfaction ratings than those that don't.
Managed Care March 2002	How Medicare beneficiaries spend money on drugs The Kaiser Family Foundation notes that Medicare beneficiaries account for 14 percent of the U.S. population, but for 43 percent of the nation's spending on prescription drugs. Thirteen percent of beneficiaries had to pay $2,000 or more out of pocket in 2001...
Managed Care December 2006 Martin Sipkoff	Federally Negotiated Drug Prices Anticipated for Medicare Part D Congress to force the issue of federally negotiated drug prices. This could eventually lead to a government-run drug plan.
BusinessWeek July 25, 2005 Arlene Weintraub	Miracle Cure -- Or Weak Medicine Why investors' hopes for a prescription drug bonanza may be premature.
Pharmaceutical Executive February 1, 2009 Jill Wechsler	Securing Savings A close look at the healthcare industry will separate real cost-cutting measures from money-saving myths.
Managed Care August 2007	Managed Care Outlook Specialty drugs increasingly used to treat chronic conditions.
The Motley Fool May 26, 2011 Brian Orelli	Congress Sets Bad Precedent With AVANIR What happened to free markets?
Managed Care March 2007 John Carroll	Democratic Agenda Places Medicare Advantage at Risk Battle lines are drawn over proposals to raid the Medicare managed care program of funds to be applied to other health care needs. Democrats themselves are split.