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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. Pharmacy benefit management - Wikipedia

   en.wikipedia.org/wiki/Pharmacy_benefit_management

   Under these laws, pharmacy benefit managers with contracts to Health care service plans are required by law to be registered with the Department of Managed Health Care to disclose information. [58] SB 966: Pharmacy benefits. SB 966: Pharmacy benefits is a California state bill written by state senators Aisha Wahab and Scott Weiner. It is ...

4. Express Scripts - Wikipedia

   en.wikipedia.org/wiki/Express_Scripts

   Express Scripts began in 1986 in St. Louis County, Missouri as a result of a joint venture between a retail chain of more than 79 pharmacies (Medicare Glaser Inc.) and Sanus Corp. Health Systems. Sanus traces its history to Bradford Systems and Administrative Services which was founded in Boston in 1968.

5. Here’s what’s in and out of the government funding agreement

   www.aol.com/government-funding-agreement...

   It would have removed the connection between the price of drugs and the compensation the PBMs receive in Medicare Part D drug plans and shifted the payment model to flat fees.

6. National Council for Prescription Drug Programs - Wikipedia

   en.wikipedia.org/wiki/National_Council_for...

   The National Council for Prescription Drug Programs (NCPDP) is an American nonprofit standards development organization representing most sectors of the U.S. pharmacy services industry. It was founded in 1977 as the extension of a Drug Ad Hoc Committee that made recommendations for the U.S. National Drug Code (NDC).

7. 35,000 Providence patients in WA could soon lose in-network ...

   www.aol.com/news/35-000-providence-patients-wa...

   About 35,000 Providence patients with Aetna insurance plans could lose coverage starting this weekend if the two don’t agree on a new contract soon, the Renton-based health care system said ...

8. Health insurance company Aetna sues Kansas government after ...

   www.aol.com/health-insurance-company-aetna-sues...

   Health insurance company Aetna is suing the state of Kansas after losing its managed care organization contract with KanCare. Aetna Better Health of Kansas filed the lawsuit July 24 in Shawnee ...

9. Medical billing - Wikipedia

   en.wikipedia.org/wiki/Medical_billing

   A medical biller then takes the coded information, combined with the patient's insurance details, and forms a claim that is submitted to the payors. [ 2 ] Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [ 4 ]