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  • WHO REALLY ‘BENEFITS’ FROM BENEFITS MANAGEMENT

    WHO REALLY ‘BENEFITS’ FROM BENEFITS MANAGEMENT

    Many benefits managers exist within the realm of the insurance industry. With the multitude of benefits management options available to an insurance company, the question of who really benefits from this relationship arises. In the case of insurance companies administering claims involving claimant use of durable medical equipment (DME), a durable medical equipment benefits manager

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  • NEVADA’S TRANSPARENCY BILL FOR INSULIN DRUG PRICING

    NEVADA’S TRANSPARENCY BILL FOR INSULIN DRUG PRICING

    The continuously rising cost of prescription Average Wholesale Prices (AWP) has been a troubling trend that impacts insurance companies, especially those within the workers’ compensation sector. Some generic prescriptions more than doubled in price between 2013 and 2014, according to a study conducted through Elsevier. Insurance companies face not only these rising prescription costs but also must address the potential for

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  • WILL THE NEW FDA COMMISSIONER HELP PHARMACY BENEFIT MANAGERS?

    WILL THE NEW FDA COMMISSIONER HELP PHARMACY BENEFIT MANAGERS?

    Several changes within the federal government have been taking place this year and perhaps none are of more interest to Pharmacy Benefit Managers (PBMs) than the recent change to the Food and Drug Administration (FDA) Commissioner role. Scott Gottlieb, M.D., has been named the new FDA commissioner and has the opportunity to impact both PBMs and

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  • FIVE REASONS WHY PHARMACY BENEFIT MANAGERS WORK BETTER

    FIVE REASONS WHY PHARMACY BENEFIT MANAGERS WORK BETTER

    Worker’s compensation and automobile no-fault claims involving prescription drugs inherently contain several challenges for insurance companies. There are many ways to address these challenges, but the most effective involves a partnership between insurance companies and pharmacy benefit managers (PBM). This article will cover the top five reasons that PBMs work better than other options. The

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  • PHARMACY BENEFIT PROGRAMS VS. MEDICAL BENEFIT PROGRAMS

    PHARMACY BENEFIT PROGRAMS VS. MEDICAL BENEFIT PROGRAMS

    The average wholesale price (AWP) of prescription drugs has been on the rise in recent years, with no foreseeable cap in sight. The American Pharmacists’ Association reported in 2015 that spending in the United States for pharmaceuticals totaled nearly $374 billion the year prior. Insurance companies are faced with even higher price tags when claimants

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