Putting Patients First Blog

JANUARY 10, 2024

Making available more specific information about total costs and coverage will ensure that all consumers have comprehensive information to help them make smart health care decisions. These resources should aim to clarify insurance terms and concepts, aiding consumers in navigating the complexities of selecting a health plan.

Insurance Coverage and Processing

Putting Patients First Blog

MARCH 15, 2024

ERISA is long overdue for Congressional attention, and we appreciate that the RFI starts this process. Patients need an affordable, functioning employer-sponsored insurance (ESI) system. It is additionally important to note that many of the people covered by private insurance have disabilities.

Insurance Coverage and Processing

Pharmaceutical Technology

NOVEMBER 30, 2022

A 2017–2018 National Health and Nutrition Examination Survey (NHANES), showed that 30.7% In the US, most private health insurers have been slow to cover the cost of anti-obesity therapeutics. Furthermore, an increase in a sedentary lifestyle, partly brought on by the Covid-19 pandemic, saw a further rise in the obese population.

Insurance Coverage and Processing

Pharmaceutical Technology

NOVEMBER 30, 2022

A 2017–2018 National Health and Nutrition Examination Survey (NHANES), showed that 30.7% In the US, most private health insurers have been slow to cover the cost of anti-obesity therapeutics. Furthermore, an increase in a sedentary lifestyle, partly brought on by the Covid-19 pandemic, saw a further rise in the obese population.

Insurance Coverage and Processing

The Thyroid Pharmacist

AUGUST 4, 2023

4] One of the key things to note is that this gene variation also prevents people from properly methylating, which is one of the body’s key detox processes that helps them get rid of toxins. However, some may be concerned with this genetic information getting reported on insurance or to employers.

Insurance Coverage and Processing

Putting Patients First Blog

MARCH 4, 2024

Under the new Manufacturer Discount Program, manufacturers will be required to provide discounts on applicable drugs during the initial coverage phase and catastrophic phase of the defined standard Part D drug benefit.

Insurance Coverage and Processing

The Thyroid Pharmacist

JUNE 30, 2023

Luckily, even without insurance coverage, this medication is available in generic form and is very affordable, usually costing between $15 to $40 per month. It’s a process and a journey, but it’s definitely worth it. Published 2018 Sep 21. It needs to be compounded into lower doses by a professional compounding pharmacy.

Compounding

Putting Patients First Blog

JULY 15, 2024

Too often the formal notice and comment process does not reach these marginalized communities and federal agencies must actively work to seek their input in non-traditional ways. This process respects their autonomy by involving them in decision-making to the extent that they are able.

Health and Personal Care Stores

PharmaShots

JUNE 28, 2023

The increase in ENBREL sales for 2019 vs 2018 was primarily driven by favorable changes to estimated sales deductions and an increase in net selling price, partially offset by lower unit demand. International sales included sales from Canada and other countries.

Biosimilars

Pharmaceutical Commerce

JUNE 13, 2025

Those patients would lose insurance coverage/access to those products, but the PBM was contractually obligated to keep the product on formulary for the other 85% of lives. The loophole I just described was what he used to process that increase. Some companies saw this as a winning commercial decision. to $750 per pill.

Insurance Coverage and Processing

The Thyroid Pharmacist

JULY 28, 2023

I’ll specify which tests are usually covered on insurance if you have a willing practitioner that can bill insurance, which tests can be self-ordered and then submitted to insurance, and which ones are usually an out-of-pocket expense that you may need to save for. You can use Health Savings Accounts for most.)

Insurance Coverage and Processing

Putting Patients First Blog

NOVEMBER 12, 2024

General Support for CMS Proposals The NHC commends CMS for its ongoing commitment to advancing health equity, improving access to care, ensuring program integrity, and maintaining affordability through Marketplace coverage. Copay Assistance and Drug Coverage in Large Group Plans Accumulator Adjustment Programs and Cost Sharing.

Insurance Coverage and Processing

Putting Patients First Blog

SEPTEMBER 9, 2024

16 We encourage CMS to continue refining these data collection processes to ensure they capture meaningful and actionable information. We believe this process is crucial for adapting the payment system to evolving clinical practices and emerging medical technologies.

Insurance Coverage and Processing

Putting Patients First Blog

JULY 7, 2023

Statement by Randall Rutta, CEO of the National Health Council, in Support of the Biden Administration’s Action to Reign-in Short Term Health Insurance Plans July 7, 2023 (Washington, D.C. The proposed rule will restore that purpose, with the appropriate patient protections in place.

Insurance Coverage and Processing

Putting Patients First Blog

SEPTEMBER 9, 2024

As these technologies become increasingly integral to patient care, it is essential for CMS to develop clear and consistent guidelines for the payment and coverage of AI-enabled services. Providing clear guidance, technical assistance, and streamlined processes can help facilitate the adoption of this innovative care model.

Insurance Coverage and Processing

Putting Patients First Blog

FEBRUARY 11, 2025

3 Establishing a feedback loop with stakeholders during this monitoring process will provide additional safeguards against adverse effects. Engaging stakeholders in transparent decision-making processes is critical to the success of risk adjustment model updates.

Insurance Coverage and Processing