Clinical Role - Payer

Pharmacy Times® is a leader in providing the latest clinical updates, patient counseling tools and innovative solutions to payers, pharmacy benefit managers, formulary chairs and directors, managed care directors, quality assurance directors, and Medicaid/Medicare directors.

National Association of Chain Drug Stores joins with 20 other groups in asking Congress to take action that includes designating pharmacists as providers under Medicare.
A new study found that Medicare Part D prescription drug insurance plans largely favor generic drugs over brand-name counterparts, despite previous reports to the contrary.
Vizient report shows that the COVID-19 pandemic resulted in a $200 million increase in the top 10 COVID-related drugs, as well as a decrease in vaccinations between March and April.
NASP
This year’s annual NASP meeting will feature an enhanced virtual environment that allows attendees to earn required CPE credits, share best practices, and browse a convention hall. 

 
The investigators noted that the shift toward value-based care has placed a greater emphasis on preventive care and chronic disease management services as delivered by multidisciplinary health care teams.
Representatives from the organizations spoke with HHS last week before President Donald Trump signed several executive orders, including one that would address manufacturer rebates also collected by PBMs.
As legislators debate the next stimulus package, pharmacists are expressing dismay that the current language does not include designating pharmacists as providers under Medicare Part B for COVID-19 testing and immunization.

 
The Heart
Individuals covered via high-deductible health care plans not found to have a greater risk of heart attack or stroke. 
contracts
Data aggregation partners can provide value in their ability to pull clinical information from both the HSSP and electronic health records.
Long-term care (LTC) pharmacies caring for this population face a myriad of unique obstacles, especially the regulatory framework surrounding them.
 
How a pharmacy performs with respect to specific measures can be associated with a DIR fee.
Birth Control
New ruling means up to 126,400 women of childbearing age may need to pay out-of-pocket for birth control.