pharmaphorum

JUNE 27, 2022

Jennifer Mathieu, director of government relations at the Academy of Managed Care Pharmacy (AMCP), tells us why the organisation backed the pre-approval information exchange (PIE) Act of 2022 and how the legislation will empower companies to share information with healthcare payers and plans during the FDA approval process. .

Insurance Coverage and Processing 82

Insurance Coverage and Processing Communication 82

Birth Control Pharmacist

JANUARY 19, 2023

Certification Requirements Here are some of the most important steps to the certification process that pharmacists should know about. If the pharmacy is mailing mifepristone, they must use a shipping service that provides tracking information. Decide who will become the authorized representative(s). Check your state policies.

Insurance Coverage and Processing 83

Insurance Coverage and Processing Health and Personal Care Stores Mail-Order Pharmacies Packaging 83

Community Pharmacy

NOVEMBER 15, 2022

If this applies to you, then you can begin your application process here to get the process started. Medicare Part D has four phases of coverage that users need to be aware of before and during enrollment in the program. In 2022, the initial coverage limit was $4,430. In 2022, the coverage gap limit was $7,050.

Insurance Coverage and Processing 52

Insurance Coverage and Processing Community Pharmacies Vaccines Hospitals 52

PharmaShots

JUNE 2, 2023

Anas Batikhi: The healthcare sector, an ongoing evolving industry on its own, is simply a flowing stream of processes, revenues & valuable health outcomes. Getting this process wrong is detrimental to any revenue collections resulting from availing services to the patient.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Health and Personal Care Stores Medical Records Documentation 40

Putting Patients First Blog

FEBRUARY 1, 2024

System-Wide Public Transparency One likely policy to be included in a health care package is increased transparency into health care costs and coverage, which is a priority of the patient community. For instance, the bill illustrates more requirements surrounding how hospitals release their annual pricing information.

Insurance Coverage and Processing 52

Insurance Coverage and Processing Packaging Hospitals 52

Putting Patients First Blog

OCTOBER 15, 2023

The specific comments below are informed by those recommendations. As the primary insurer for millions of Americans and as the programs that drive decisions throughout the health ecosystem, these federal programs can be a critical driver of innovations.

Insurance Coverage and Processing 40

Insurance Coverage and Processing 40

Putting Patients First Blog

APRIL 29, 2024

Periodic Reviews : We suggest conducting periodic reviews of the MPPP’s impact based on quantitative data and qualitative feedback to inform targeted improvements. By prioritizing such inclusivity, CMS can better fulfill its mission to deliver support and information to all beneficiaries.

Documentation 40

Documentation Insurance Coverage and Processing Communication Pharmacy Technician 40

Putting Patients First Blog

MARCH 18, 2024

While implementing this new program, it will be critical that CMS work with patients, patient advocacy groups, and other stakeholders to support choice and access to clear, understandable, and actionable information.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Communication Documentation Mail-Order Pharmacies 40

Putting Patients First Blog

MARCH 18, 2024

While implementing this new program, it will be critical that CMS work with patients, patient advocacy groups, and other stakeholders to support choice and access to clear, understandable, and actionable information.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Communication Documentation Mail-Order Pharmacies 40

The Thyroid Pharmacist

JULY 28, 2023

Figuring out which tests you should do can be overwhelming because there’s quite a bit of information out there, and there are multiple tests that can give us an idea of our current thyroid function, as well as triggers that can reveal why the thyroid may be malfunctioning. You can use Health Savings Accounts for most.)

Insurance Coverage and Processing 81

Insurance Coverage and Processing Immunity Immunization Dosage 81

Pharma in Brief

FEBRUARY 2, 2022

The feedback will inform a stakeholder session in spring 2022 and the Panel’s final report. In Canada, coverage for prescription drugs exists through an array of public and private drug plans. The Panel is asking for feedback on the framework with an online questionnaire. Background. a formulary); and.

Insurance Coverage and Processing 59

Insurance Coverage and Processing Biosimilars Diabetes 59

Putting Patients First Blog

MARCH 4, 2024

Ensure Comprehensive Transparency in Formulary Management: Provide clear, comprehensive guidelines to Part D plans to ensure transparency in plan coverage, tiering, and utilization management (UM) policies, offering safeguards against practices that could restrict access to necessary treatments.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Communication Hospitals 40

Putting Patients First Blog

DECEMBER 13, 2023

This will also be an input into a significant initiative the NHC will undertake to improve the listening sessions and other patient engagement activities at CMS. All these issue areas have garnered bipartisan interest and will remain top of mind for the NHC.

Insurance Coverage and Processing 52

Insurance Coverage and Processing Drug Pricing Packaging 52

Putting Patients First Blog

MARCH 29, 2023

Provisions to Ensure Coverage During Future PHEs The pandemic has underscored the importance of meaningful, affordable health insurance coverage. Making sure that the greatest number of people possible have coverage during a PHE is critical to assuring that patients and our health care system are protected during a PHE.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Vaccines Documentation Hospitals 40

pharmaphorum

JULY 19, 2021

While recent years have seen an increase in the number of people who are insured, growth in out-of-pocket costs for many people with commercial insurance has outpaced growth in health plan costs, and premiums continue to rise. Right now, many of the sickest patients are burdened with most of the costs. We all need to do better.”.

Insurance Coverage and Processing 105

Insurance Coverage and Processing Vaccines Documentation Immunity 105

Proxsys Rx

APRIL 4, 2024

Optimizing visibility allows for clinicians to avoid duplication of efforts, and ensure safety and efficacy — with full laboratory data, and other relevant information (i.e., In other words, Novartis informed 340B health systems that they would soon allow them to use only pharmacies within a 40-mile radius of their primary campuses.

Specialty Pharmacies 52

Specialty Pharmacies Hospitals Insurance Coverage and Processing Medication Dispensing 52

FADIC

OCTOBER 24, 2023

FDA approval process The FDA regulates both OTC and prescription drugs, but in different ways. Prescription drugs have to go through the New Drug Application (NDA) process. The application includes submitting clinical drug trial data and information about the manufacturing process.

Health and Personal Care Stores 52

Health and Personal Care Stores Insurance Coverage and Processing Labelling Dosage 52

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. Beneficiaries should have access to information that helps them understand their premiums and overall Part D costs.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Communication Hospitals 40

pharmaphorum

OCTOBER 1, 2022

In this latest coverage, pharmaphorum speaks with Eugene Borukhovich. He expects to see many new faces presenting, speaking in panel discussions, and much more: “That’s where you get the real deal information, right? The impacts of this, as we’ve seen, are insurers are on an acquisition spree at the moment,” Borukhovich says.

Insurance Coverage and Processing 94

Insurance Coverage and Processing Hospitals 94

Putting Patients First Blog

JUNE 5, 2023

This is not a venue that patients and their advocates have access to, as health insurance plans are the primary users of the portal. CMS must ensure stakeholders have ample opportunity to provide input throughout the implementation and adjustment process. A simple 30-day comment period process will likely not be sufficient.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Communication 40

Proxsys Rx

SEPTEMBER 26, 2023

Even with her insurance coverage, the co-pay was beyond her means. The gentleman in question had no health insurance coverage at all, and the cash price for his prescription was far beyond his means to pay. For more information, contact Howard Hall. Our pharmacists were only too happy to help.

Insurance Coverage and Processing 52

Insurance Coverage and Processing Hospitals Prescription Filling Specialty Pharmacies 52

pharmaphorum

AUGUST 31, 2021

Their efforts pave the way for others, who can learn from the successes and failures to inform their own ECAs. We have seen some select examples of this across the industry, but in order to get to state where there is more widespread application of them, a more systematic approach to ECAs must be embedded into the overall development process.

Insurance Coverage and Processing 70

Insurance Coverage and Processing Drug Development Documentation Labelling 70

pharmaphorum

NOVEMBER 1, 2022

Not unlike the financial industry, these institutions still exchange patient information via fax machines. As in finance, traditional healthcare stakeholders tend not to share information very efficiently with their competitors. Facilitating digital interoperability among these various stakeholders is paramount.

HIPAA 98

HIPAA Insurance Coverage and Processing Specialty Pharmacies Communication 98

ID Stewardship

JUNE 6, 2023

We’ll dive into the many ways AI can assist pharmacists, from streamlining medication dispensing processes to enhancing patient education. Personalized Medication Recommendations : AI algorithms can process patient data, such as age, gender, medical conditions, and allergies, to generate tailored medication recommendations.

Insurance Coverage and Processing 52

Insurance Coverage and Processing Prescription Filling Hospitals Medication Dispensing 52

pharmaphorum

APRIL 29, 2021

Officially launched in 2016, Kaia’s technology can now be accessed by 60 million patients worldwide and it claims to be the biggest player in digital MSK in terms of coverage. The benefits of insurance firms are focused on main HQ offices.”. billion invested in the sector in Q1 alone. A remote workforce is the perk of the future.”.

Insurance Coverage and Processing 66

Insurance Coverage and Processing 66

Proxsys Rx

NOVEMBER 8, 2023

Even with her insurance coverage, the co-pay was beyond her means. The gentleman in question had no health insurance coverage at all, and the cash price for his prescription was far beyond his means to pay. For more information, contact Howard Hall. Our pharmacists were only too happy to help.

Insurance Coverage and Processing 40

Insurance Coverage and Processing Hospitals Prescription Filling Specialty Pharmacies 40

European Pharmaceutical Review

MARCH 28, 2024

Mindy’s background in project management, software development and information architecture came in handy when designing a PRO programme for her son, Aidan, a 14-year-old with Duchenne Muscular Dystrophy. That PRO programme then proved instrumental in the approval of EXONDYS51, the first FDA-approved treatment for Duchenne.

Insurance Coverage and Processing 52

Insurance Coverage and Processing Packaging Communication 52

Proxsys Rx

AUGUST 22, 2023

Optimizing visibility allows for clinicians to avoid duplication of efforts, and ensure safety and efficacy — with full laboratory data, and other relevant information (i.e., In other words, Novartis informed 340B health systems that they would soon allow them to use only pharmacies within a 40-mile radius of their primary campuses.

Specialty Pharmacies 52

Specialty Pharmacies Hospitals Insurance Coverage and Processing Medication Dispensing 52

Pharmaceutical Technology

NOVEMBER 30, 2022

In the US, most private health insurers have been slow to cover the cost of anti-obesity therapeutics. Medicare Part A, Part B, and Part D do not generally cover approved weight loss medications like Saxenda, but Medicare Advantage plans may allow for expanded coverage, as per the Medicare.org site.

Insurance Coverage and Processing 105

Insurance Coverage and Processing Diabetes Labelling Communication 105

Pharmaceutical Technology

NOVEMBER 30, 2022

In the US, most private health insurers have been slow to cover the cost of anti-obesity therapeutics. Medicare Part A, Part B, and Part D do not generally cover approved weight loss medications like Saxenda, but Medicare Advantage plans may allow for expanded coverage, as per the Medicare.org site.

Insurance Coverage and Processing 98

Insurance Coverage and Processing Diabetes Labelling Communication 98

Proxsys Rx

DECEMBER 22, 2023

Optimizing visibility allows for clinicians to avoid duplication of efforts, and ensure safety and efficacy — with full laboratory data, and other relevant information (i.e., In other words, Novartis informed 340B health systems that they would soon allow them to use only pharmacies within a 40-mile radius of their primary campuses.

Specialty Pharmacies 40

Specialty Pharmacies Hospitals Insurance Coverage and Processing Medication Dispensing 40

Proxsys Rx

AUGUST 16, 2023

“Wholesale Acquisition Cost prices occur pre-rebate and prior to price negotiations between drugmakers and buyers — the pharmacy benefit managers, federal payers and commercial health insurers — in the prescription drug supply chain. Irrespective of insurance status, no patient pays retail drug prices.

Insurance Coverage and Processing 52

Insurance Coverage and Processing Hospitals Drug Pricing Pharmaceutical Companies 52

Pharmaceutical Technology

FEBRUARY 7, 2023

Launching a new drug can be a risky business, with regulatory approval no guarantee that private, commercial, and government-funded insurers will reimburse it. Meanwhile, in Germany, the AMNOG process is conducted twelve months after the drug is launched, thus giving freedom to the company to set the drug’s price during this period.

Insurance Coverage and Processing 52

Insurance Coverage and Processing Inpatient Drug Pricing Packaging 52

Putting Patients First Blog

JULY 3, 2023

We encourage the CMS to engage providers and patients in this process to decrease the overall burden on and encourage provider participation. This is important to patients as this quality information is one of the key factors used to help select a plan — in addition to cost.

Insurance Coverage and Processing 40

Insurance Coverage and Processing 40

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 105

Insurance Coverage and Processing Immunity Immunization Dosage 105

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

Viseven

JULY 11, 2023

The provider’s team used to spend 80 hours processing a list of potential clients. Humana , a US-based health insurance company, took advantage of a few Salesforce products at once to build a single view around their customers. With Salesforce, they do it for 15 minutes.

Health and Personal Care Stores 40

Health and Personal Care Stores Insurance Coverage and Processing Scheduling Appointments Communication 40