Reimbursement

The Pharmacy Times® Reimbursement resource center provides clinical news and articles, information about reimbursement for clinical pharmacy services.

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The changes, finalized today, are generally effective for the 2022 plan year and will potentially lower enrollee cost sharing on some of the most expensive prescription drugs.
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Katea Ravega, a partner at Quarles and Brady LLP, discussed the recent Supreme Court ruling in Rutledge v. PCMA and what it could mean for the future of states’ legislation around PBMs.
 
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This week on Pharmacy Times, there are a number of important topics that will be covered and posted throughout the week.
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There are many benefits to adopting and integrating new technological methods for hosting pharmacy organization events.
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Supreme Court ruling clears the way for states to pass laws that protect pharmacies from predatory reimbursement practices by PBMs.
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Supreme Court decision establishes that states do have the right to regulate pharmacy benefit managers in managed care organizations.
 
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If current drug pricing trends continue, cost-related non-adherence to therapy will result in the premature deaths of 112,000 Medicare beneficiaries per year.
 
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Pharmacists must demonstrate value to achieve success when implementing new services and especially when establishing an entirely new practice.
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Medicaid expansion has helped to increase annual checkups among low income individuals. 
 
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The combination of COVID-19 with opioid-induced respiratory depression, especially in an elderly patient, could be deadly.
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Trends and comfort levels have changed among consumers, pharmacies, and payers from 2019 to 2020 as it relates to pharmacist-provided services and value-based performance programs.
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Throughout the pandemic, pharmacists have played a critical role in the COVID-19 response in several ways