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Search Results for: þ˸ via370.top ¶ ׾˿ڸ 彺̴ó ڽƽ Ź ? GHB ó ŷ – Page 2

Health Insurance Marketplace (ACA)

July 19, 2016
The Affordable Care Act (ACA) established new Health Insurance Marketplaces, through which individuals and small business can purchase health coverage. No matter which state an individual lives in, all Marketplace health plan options must offer patients ten standardized categories of benefits — referred to as Essential Health
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Medicare Part D

July 19, 2016
Created by the Medicare Modernization Act of 2003, Medicare Part D provides a prescription drug benefit to Medicare enrollees. The Part D benefit is administered by private stand-alone drug plans and Medicare Advantage drug plans. Over the last decade, market-based
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Employers, Unions, & Insurers

July 19, 2016
PBMs administer prescription drug plans for more than 266 million Americans with health coverage provided through Fortune 500 employers, health insurers, and labor unions, as well as through public programs such as Medicare and Medicaid. A common thread connecting all programs
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Drug Abuse Prevention

August 18, 2016
PCMA supports the creation of “Safe Pharmacies” in Medicare Part D for Controlled Prescription Drugs. The creation of “Safe Pharmacies,” or a “Lock-In” program in Part D for controlled substances, will allow Part D plans to require at-risk beneficiaries to
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Value & Outcomes-Based Contracting

July 19, 2016
PBMs and payers are committed to the affordability and sustainability of the healthcare system and recognize the importance of aligning reimbursement around value instead of volume. Traditionally, risk-sharing agreements between payers and drug manufacturers have not been tied to the
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Fraud, Waste, & Abuse

July 19, 2016
PBMs employ a variety of state-of-the-art techniques when working with pharmacies and other stakeholders to combat fraud, waste, and abuse. Vigilance against fraud is paramount to ensure that scarce health care resources are used for legitimate purposes. According to PCMA-sponsored
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Drug Coupons & Assistance Programs

July 19, 2016
Drug companies rely on financial subsidy programs to increase product uptake among insured patients. Unlike means-tested patient assistance programs, which assist uninsured or indigent populations, copay assistance and free drug programs target patients who are already covered by insurance plans.
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Pharmacy Contracting & Reimbursement

July 19, 2016
PBMs contract with pharmacies on behalf of health plans and employers to serve patients by building networks of preferred pharmacies. As part of the negotiations to become a preferred network provider, pharmacies and PBMs negotiate contract types, payment rates for
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