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  2. 340B Drug Pricing Program - Wikipedia

    en.wikipedia.org/wiki/340B_Drug_Pricing_Program

    (3) Over half of states developed alternatives to OPA's Medicaid Exclusion File to identify 340B claims and prevent duplicate discounts. [44] Recommendations: (1) The Centers for Medicare & Medicaid Services (CMS) should direct states to create written 340B policies. (2) CMS should inform States about tools they can use to identify claims for ...

  3. Preferred provider organization - Wikipedia

    en.wikipedia.org/wiki/Preferred_provider...

    Unlike EPO members, however, PPO members are reimbursed for using medical care providers outside of their network of designated doctors and hospitals. However, when they use out-of-network providers PPO members are reimbursed at a reduced rate that may include higher deductibles and co-payments, lower reimbursement percentages, or a combination ...

  4. GoodRx - Wikipedia

    en.wikipedia.org/wiki/GoodRx

    GoodRx Holdings, Inc., is an American healthcare company that operates a telemedicine platform and free-to-use website and mobile app that track prescription drug prices in the United States and provide drug coupons for discounts on medications. [3] GoodRx checks drug prices at more than seventy-five thousand pharmacies in the United States.

  5. Medicaid - Wikipedia

    en.wikipedia.org/wiki/Medicaid

    Medicaid is a government program in the United States that provides health insurance for adults and children with limited income and resources. The program is partially funded and primarily managed by state governments, which also have wide latitude in determining eligibility and benefits, but the federal government sets baseline standards for state Medicaid programs and provides a significant ...

  6. Medicare Sustainable Growth Rate - Wikipedia

    en.wikipedia.org/wiki/Medicare_Sustainable...

    The Medicare Sustainable Growth Rate (SGR) was a method used by the Centers for Medicare and Medicaid Services (CMS) in the United States to control spending by Medicare on physician services. [ 1 ] President Barack Obama signed a bill into law on April 16, 2015, the Medicare Access and CHIP Reauthorization Act of 2015 , which ended use of the ...

  7. Keystone First - Wikipedia

    en.wikipedia.org/wiki/Keystone_First

    Keystone First is a medical assistance (Medicaid and Medicare) managed care health plan based in southeastern Pennsylvania. Keystone focuses on low-income residents in southeastern Pennsylvania counties including, Bucks, Chester, Delaware, Montgomery, and Philadelphia. The healthcare provider currently serves over 400,000 residents in the area.

  8. Payment card interchange fee and merchant discount antitrust ...

    en.wikipedia.org/wiki/Payment_Card_Interchange...

    Class members can opt out of the monetary part of the settlement in addition to objecting in court. Visa, MasterCard, and issuing banks can scuttle the settlement if merchants that account for 25 percent or more of credit card spending in the United States since January 1, 2004, to the approval of the settlement.

  9. Merit Network - Wikipedia

    en.wikipedia.org/wiki/Merit_Network

    The Michigan Educational Research Information Triad (MERIT) was formed in the fall of 1966 by Michigan State University (MSU), University of Michigan (U-M), and Wayne State University (WSU). [2] More often known as the Merit Computer Network or simply Merit, it was created to design and implement a computer network connecting the mainframe ...