Tag: health-insurance
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Explaining the So-Called “Prompt Pay” Legislation
Under current law, section 146.905 of the Wisconsin Statutes prevents Wisconsin healthcare providers from offering to reduce or eliminate copays, coinsurance, or deductibles that are required under an insurance policy. The Wisconsin Hospital Association says that this section of the statute prohibits healthcare providers from offering discounts to patients who pay their bills promptly. Legislation…
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Will a Proposed Ban on White Bagging Rise from the Ashes?
White bagging, or alternative sourcing of medications, is when employers work with their preferred pharmacy partners to send an enrollee’s clinician-administered medication directly to the site of care, when it is both safe and cost effective to do so. This allows employers to bypass hospital pharmacy markups on expensive specialty medications, which according to studies…
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PBM Reforms Proposed in Madison and D.C.
Pharmacy Benefit Manager (PBM) reform is a hot topic in Congress and in statehouses around the country. Several factors have led to the increased scrutiny. Numerous reports and investigations, including by the Federal Trade Commission and the US Department of Justice, conclude that PBM pricing strategies are inflating costs for consumers and employers. And, because…