Over the last decade, however, Minnesota has lost more independent pharmacies than any other state. The demise of independent pharmacies in Minnesota and many other places is being hastened by another group of businesses — the PBMs.
Minnesota is losing independent pharmacies, victims of scale, efficiency More »
UnitedHealth Group limits the ability of its workers to deviate from the AI projections, according to the lawsuit. Citing the news article, the complaint says employees who don’t follow the model are disciplined and terminated, without regard to whether patients needed more care.
Lawsuit against UnitedHealth Group of using faulty AI to deny Medicare patient claims More »
The nation’s largest health insurance company pressured its medical staff to cut off payments for seriously ill patients in lockstep with a computer algorithm’s calculations, denying rehabilitation care for older and disabled Americans as profits soared, a STAT investigation has found. UnitedHealth Group has repeatedly said its algorithm, which predicts
UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients’ rehab care More »
The document from Allina Health arrived in February, stating the 61-year-old Woodbury resident owed the hospital a staggering sum — $155,493. It made no sense, Christensen said. He had coverage through his employer from a reputable health insurer. And the need for the care was undeniable; Christensen was hospitalized for
The care was crucial. He had insurance. His hospital bill? A whopping $155,493. More »
In theory, pharmacy benefit managers like to recommend generic drugs and keep prices lower than brand-name pharmaceuticals. But it doesn’t always work out that way when the same company owns a PBM and the retail pharmacy — it can be in the company’s interest to keep prices higher.
Generic drugs get a markup at CVS, Cigna, UnitedHealth report says More »
Today, United is the fifth-largest public company in the U.S., bigger than JPMorgan Chase. Its insurance products serve 50 million members, more than the population of Spain, and its $186 billion health services division, Optum, has 103 million patients, more than Vietnam’s population. Earnings came to $28.4 billion last year,
Health Care’s Intertwined Colossus More »
“Large insurance companies continue to do all they can to deny, delay or reduce payments for emergency care,” Dr. Christopher Kang, president of the American College of Emergency Physicians, said in a statement. “Immediate action to strengthen enforcement of the prudent layperson standard and other existing laws can help hold
U.S. Department of Labor sues UnitedHealth Group over thousands of denied claims More »
Underpayment from Caremark has caused many non-CVS pharmacies to close, creating “pharmacy deserts” in many urban neighborhoods and rural areas. CVS Health has been able to achieve and abuse its power through a series of mergers and acquisitions. Had our existing antitrust laws — such as the Clayton Act —
CVS hellth – Corporate consolidation is ruining pharmacies and hurting patients More »
Three major companies control 80% of the prescription-drug market: Optum, ExpressScripts, and CVS Caremark. These companies leverage their dominance to engage in practices like “patient steering,” which is requiring patients to fill prescriptions at their pharmacies, even when it’s less convenient. “Spread pricing” is another tactic, whereby PBMs reimburse pharmacies
Minnesota Pharmacist’s View: Losing local pharmacies a hazard to Minnesotans’ health care More »
Deborah Leedahl, owner of the pharmacy and gift shop in downtown Elk River, told the Star News there were a lot of factors that went into the decision to close, but the primary reason is pharmacy benefit managers who have been chipping away at her profits for years. The last
Elk River landmark, Kemper Drug, closes suddenly More »
