Health insurance is designed to cover patients when they get sick, but what happens when insurance companies stamp “reject” on a claim? Some of those patients may end up sicker, suggests a recent survey entitled “Not What the Doctor Ordered” from the Doctor-Patient Rights Project (DPRP). Health insurers denied coverage for nearly a quarter ofRead more about Health insurer denials may be making Americans sicker[…]

Pharmacy Benefit Managers (PBMs), the goliath health insurance middle-men wedged between plan managers, drug manufacturers, patients and pharmacies, make huge profits by forcing pharmacies to pay back a portion of drug sales after the sale has been completed. It is a profitable business model in today’s healthcare industry. The practice is called a “clawback,” andRead more about Pharmaceutical middle men reforms would save patients and taxpayers billions[…]

LANSING, MI (WNEM) – Michigan pharmacists are trying to lower the cost of your prescriptions and are asking you to stand up with them against inflated and shadowy pricing practices. “Becomes rather frustrating for the community pharmacist,” said Larry Wagenknecht, CEO of the Michigan Pharmacists Association. Wagenknecht believes too many people are being forced toRead more about Pharmacists start campaign to lower prescription drug prices[…]

MILBRIDGE — With the recent news about increases in premiums for health plans sold through the Affordable Care Act marketplace, everyone wants to vilify the ACA. The ACA is but a symptom of the issue. Where are our policy dollars going? As a primary care physician, I am on the front lines. Milbridge is remote.Read more about Maine Voices: The problem isn’t Obamacare; it’s the insurance companies[…]

In the past few months, four bills have been introduced in Congress calling for transparency in prescription drug pricing. These bills—HR 1038, HR 1316, S.3308 and, earlier this week, one called C-THRU—largely concern pharmacy benefit managers (PBMs), a heretofore largely unrecognized component of the pharmaceutical industry. PBMs quietly became an integral part of the pharmaceuticalRead more about UNDERSTANDING THE HIDDEN VILLAIN OF BIG PHARMA: PHARMACY BENEFIT MANAGERS[…]

Detroiter Glenn Ford, 63, could have avoided a trip to the emergency room recently if he’d taken the medicine his doctor prescribed. Ford’s insurance company wouldn’t authorize the prescription, despite numerous appeals from his physician. The prescription costs more than $300 out-of-pocket, so Ford never had it filled. Read the article

President Donald Trump isn’t delaying his promise to repeal and replace Obamacare. On his first business day in office, he signed an executive order offering some relief from the law’s oppressive regulations. Congress is equally eager to take action, but any major shakeup will create challenges for the states — especially the ones that expandedRead more about Our Editorial: Prepare now for Obamacare shakeup[…]

West Michigan’s cost advantages for health care services may be eroding. According to the annual Health Check report from Grand Valley State University’s Seidman College of Business, treating coronary artery disease in West Michigan cost an average of $25,895 per member two years ago, an increase of 22 percent. That compares to an average per-memberRead more about Health care costs continue to rise in Grand Rapids compared to peer cities[…]

Mallinckrodt Pharmaceuticals company has agreed to pay $100 million to settle a lawsuit alleging that a company it acquired in 2014 engaged in anti-competitive behavior to preserve its monopoly on a $34,000-a-vial infantile spasm medicine. Read the Article

Lansing – Michigan residents and schools will have an easier time obtaining life-saving medication to reverse opioid drug overdoses under a series of bipartisan bills Lt. Gov. Brian Calley signed into law Wednesday. The House legislation allows pharmacists to dispense opioid antagonists without a prescription under a standing order from the state’s chief medical executive.Read more about New Michigan laws boost access to opioid overdose drugs[…]