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In the US, where a system of quasi-private healthcare is in place, a formulary is a list of prescription drugs available to enrollees, and a tiered formulary provides financial incentives for patients to select lower-cost drugs. For example, under a 3-tier formulary, the first tier typically includes generic drugs with the lowest cost sharing ...
Step therapy, also called step protocol or a fail first requirement, is a managed care approach to prescription.It is a type of prior authorization requirement that is intended to control the costs and risks posed by prescription drugs.
The Maryland Health Connection (administered by the Maryland Health Benefit Exchange) is the health insurance marketplace in the U.S. state of Maryland, created in accordance with the Patient Protection and Affordable Care Act. [1] The marketplace is offered to individuals and families who are not covered through their employers.
Pharmacy and Therapeutics (P&T) is a committee at a hospital or a health insurance plan that decides which drugs will appear on that entity's drug formulary.The committee usually consists of healthcare providers involved in prescribing, dispensing, and administering medications, as well as administrators who evaluate medication use. [1]
The AHFS DI is one of several compendiums [1] approved by the Social Security Act (Section 1861(t)(2)(B)(ii)(I)) as a source of off-label anti-cancer drug use. [2] [3] It was originally published in 1959 as the American Hospital Formulary Service (AHFS) by the American Society of Health-System Pharmacists.
MedStar Family Choice is a managed care organization serving the District of Columbia and Maryland. Coverage is provided for participants in DC, [38] and Maryland. [39] Maryland Children's Health Program [40] MedStar Health Research Institute (MHRI) [41] offers research support for MedStar's medical and instructional services.
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In this system, health care costs are first paid for by an allotment of money provided by the employer in an HSA or HRA. Once health care costs have used up this amount, the consumer pays for health care until the deductible is reached, after this point, it operates similar to a typical PPO. Once the out-of-pocket maximum is reached, the health ...