Integra X Files

MAY 22, 2023

Prior authorization has been popular with the insurance industry because it works. This is known as the sentinel effect, and in the initial stages, providers accommodated the process without much complaint. The health insurance industry didn’t have many other tools to suppress demand, so it went with the sentinel effect by default.

Insurance Coverage and Processing 94

Insurance Coverage and Processing Health Insurance Companies 94

Putting Patients First Blog

JANUARY 16, 2024

The NBPP is a set of rules and guidelines issued annually by CMS that outline the policies and standards for health insurance plans and issuers, primarily focusing on the Health Insurance Marketplace under the Affordable Care Act. These are the rules for the federal health insurance marketplace for the coming year.

Insurance Coverage and Processing 59

Insurance Coverage and Processing Communication 59

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 40

Insurance Coverage and Processing Communication Hospitals 40

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 40

Insurance Coverage and Processing Communication Documentation Diabetes 40

Express Pharma

JANUARY 12, 2024

. – Considering that the government promotes companies to “Make in India”, we request that the time limit for commencing manufacturing or production be further extended to 31 March 2026. Therefore, the sunset period should be extended for borrowings in foreign currency up to 31 March 2026; this would support the vision of “Make in India”.

Insurance Coverage and Processing 52

Insurance Coverage and Processing Pharmaceutical Companies Pharmaceutical Companies Health Insurance Companies 52

Big Molecule Watch

AUGUST 25, 2023

Congress left Medicare drug pricing to the drug manufacturers, pharmacies, and insurance plan sponsors to determine, and expressly prohibited the government from “interfering” in those private price negotiations under the so-called “Non-Interference Clause” of the Medicare Modernization Act of 2003.

Drug Pricing 40

Drug Pricing Biosimilars Insurance Coverage and Processing Labelling 40