New Code WACK! episode
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How Pharmaceutical
Profiteers Are
Screwing Us Over
Featuring Hannah Garden-Monheit
Federal Trade Commission
Breaking News in Healthcare Reform
Snippets of news & commentary with a special focus on
health policy, Medicare for All & California
Like Weekly News Roundup? Then you’ll love our popular podcast Code WACK! where we shine a light on the outrageous hassles patients face when dealing with America’s callous healthcare system. Subscribe below!
“PBMs [Pharmacy Benefit Managers] say their rebate system drives down drug costs. But health care advocates argue patients are the real losers.”
It’s Not Just Big Pharma: Meet the Middlemen Blocking Access to Medication
Truthout | Katie Rose Quandt | August 31, 2024
“Under [California] law, health insurance companies must cover contraceptive drugs, devices and products such as birth control and intrauterine devices (IUDs) at no cost to the patient. The Department of Managed Health Care found that from 2016 through 2019, Blue Shield had charged more than 330 members for those services.”
California Fines Blue Shield for Illegally Charging Patients for Contraceptives
KQED | Adhiti Bandlamuti | August 30, 2024
“The $850,000 combined penalties against Anthem Blue Cross also require the insurer to hire a dedicated case manager for people with gender dysphoria.”
Health Insurer Hit with California’s Largest-Ever Penalty Over Gender-Affirming Care Denials
CalMatters | Shaanth Nanguneri | August 30, 2024
“Testimony from the heads of Express Scripts, Optum Rx and Caremark in July defending pharmacy benefit managers’ business practices could be coming back to bite them.”
PBM Executives Threatened with Fines and Jail Time for Alleged Perjury in House Hearing
Healthcare Dive | Rebecca Pifer | August 29, 2024
“A recent report from the Federal Trade Commission, which is investigating pharmacy benefit managers, suggests that the largest organizations may be engaging in practices specifically to evade regulation, such as moving portions of their operations out of the country.”
These Middlemen Say They Keep Drug Prices Low. California Lawmakers Don’t Buy It
CalMatters | Kristen Hwang | August 28, 2024
“Today, nearly 15 percent of all claims are initially rejected, leading patients who think they have comprehensive insurance to find themselves blindsided when they seek medical care.”
Troubling Health Care Trends Need Attention
Insurance News Net | John Allard, InsideSources, Waco Tribune-Herald | August 28, 2024
“…Medicare Part D spending could increase by $34 billion to $145 billion each year, according to new research.”
Semaglutide Coverage for Weight Loss Could Cost Medicare Billions: Study
Axios | Emily Olsen | August 27, 2024
“A select group of private equity-backed physician practices benefited from the federal process for resolving billing disputes for out-of-network care, collecting payouts well above what insurers would have paid in-network….”
Surprise Billing Law Helped PE-Backed Providers
Axios | Adriel Bettelheim | August 26, 2024
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