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STAT+: FTC slams PBMs for boosting specialty drug prices at the expense of the U.S. health care system

STAT

The latest report accuses the PBMs – CVS Caremark, OptumRx and Express Scripts, all of which are owned by large health insurers – of boosting prices of specialty generic drugs that are sold through their own pharmacies. Specifically, the companies were able to generate more than $7.3

Insurance 144
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Merck settles with insurance companies over $1.4B claim tied to 2017 cyberattack: report

Fierce Pharma

Merck has reportedly settled with insurance companies that contested the pharma giant’s $1.4 billion claim after it was victimized by a crippling cyberattack in 2017. Merck has settled with insurance companies that contested the pharma giant’s $1.4

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STAT+: Medicare Advantage insurers will score $2 billion gift thanks to limited audits

STAT

Medicare officials made a clear statement four years ago about how best to audit the country’s Medicare Advantage insurers: Failing to take back all overpayments “would be contrary to the public interest.” The amount of taxpayer money that insurers will get to keep because of that decision: $2 billion.

Insurance 114
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Opinion: Your health insurance may not be as good your state requires — and it’s perfectly legal

STAT

In 2017, the Massachusetts state Legislature passed a law to ensure ease of access to birth control. The state mandates that plans cover “ medically necessary expenses of diagnosis and treatment of infertility ” if the insurance provides other pregnancy-related benefits. Because many companies are “self-insured.”

Insurance 118
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How much is NuvaRing (etonogestrel-ethinyl estradiol) without insurance?

The Checkup by Singlecare

Without insurance, the prescription birth control, NuvaRing, costs $234 for 1, 0.12-0.015 Is NuvaRing covered by insurance? Most health insurance plans usually cover NuvaRing. This means your insurance company wants to verify NuvaRing is medically necessary before they agree to cover it. 0.015 mg/24-hour ring.

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Merck, insurers advance fight over cyberattack-related coverage to New Jersey Supreme Court

Fierce Pharma

scored a legal win in the insurance case tied to the 2017 "NotPetya" cyberattack, the case is in appeals—again. scored a legal win in the insurance case tied to the 2017 "NotPetya" cyberattack, the case is in appeals—again. About a month and a half after Merck & Co. That didn't take long.

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STAT+: Former medical device CEO who sold fake plastic parts sentenced to 6 years in prison

STAT

Under CEO Laura Perryman’s leadership, the company warped the design of their devices to earn more reimbursement money from insurers, resulting in unnecessary plastic parts that allowed doctors to claim around $18,000 more than they previously could. From 2017 to 2020, the company sold nearly 8,000 devices with the fake component.

Insurance 135