In the past month, Ohio Attorney General Dave Yost has sought financial information from the state’s five managed-care contractors, documents received in response to an open-records request show. The AG won’t discuss ongoing investigations, but he might be looking into whether some practices by subcontractors who manage pharmacy benefits violate state law or federal regulations.

Sara Sharpe, 34, has a pretty basic wish: She doesn’t want to suffer a potentially fatal allergic reaction “because of insurance company paperwork” foul-ups. She is one of millions nationwide caught up in a money-saving move by health insurance companies with the unwieldy name of “co-pay accumulators.” People in this diverse group, many suffering from rare diseases, are casualties of…

There’s been a lot of talk about ways to reduce the cost of prescription drugs. In last week’s State of the Union Address, for example, President Joe Biden proposed allowing Medicare to negotiate directly with drugmakers in an attempt to bring prices down.

In theory, the point of managed care is to save money by negotiating with providers for lower prices. So it would seem that the biggest managed-care providers would use their clout to negotiate the lowest prices from doctors and hospitals and for medicine…

Members of Congress last week took up an issue potentially of great importance: What to do about powerful health conglomerates who play an increasingly powerful role in the drug-supply chain…

At issue is whether “patient steering” can be discriminatory

Rules block patients from counting thousands in drug discounts toward health insurance deductible

In what could be a harbinger of more settlements, Medicaid managed-care contractor Centene on Monday settled potential fraud claims by Ohio and Mississippi for $88.3 million and $55 million, respectively.

Policymakers Should Ban the Use of the Quality Adjusted Life Years (QALY) Methodology in Evaluating New Cancer Therapies & Prohibit ICER from Advising Government Agencies Media inquiries: Contact Micaela Dawson, mdawson @pioneerinstitute .org Boston – Pioneer Institute today released a new analysis, The QALY and Cancer Treatments: An Ill-Advised Match, that examines the alarming methodological and contextual shortcomings of…