Pharmacy Benefits Management companies (PBMs) news from FierceHealthcare

Recently, the industry has seen a string of cases in which pharmacy benefit managers have agreed to fork over settlements over allegations of bad behavior. Most recently, this includes the instance Read more...

In the newest attack in the increasingly ugly battle for control of Caremark Rx, rival PBM Express Scripts--currently the spurned suitor--called a dividend offer from drugstore chain CVS a "desperate attempt to save a flawed transaction.". Following yesterday's offer by Express Scripts to take over Caremark, valued at $24.8 billion to $25 billion, depending on whose numbers you believe, CVS sweetened its bid by offering a special cash dividend of $2 per share to Caremark shareholders, …

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Express Scripts is moving ahead with its $25 billion plan to take over rival PBM  Caremark Rx, announcing Tuesday that it has begun offering cash and shares to Caremark shareholders, despite being rebuffed by the Caremark board last week. That move follows a lawsuit by a large institutional investor that charges Caremark insiders with putting personal enrichment ahead of shareholder value. In a suit filed last month but not reported until Friday, the Louisiana Municipal Police …

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Prosecutors in Manhattan have launched a criminal investigation into stock-option grants to senior executives at UnitedHealth. The Minnetonka, Minnesota-based health insurer also said the IRS has asked for access to documents, suggesting that an investigation into tax issues may be a possibility. For weeks, the consensus has been that it is unlikely that CEO William McGuire will resign as a result of the affair. Criminal charges could change things in the blink of an eye. UnitedHealth …

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> Hospitals in Pennsylvania, including the University of Pittsburgh Medical Center network, are providing more uncompensated care than last year, a local industry trade group reports. Article

> Blue Cross of Massachusetts will double the amount it spends on pay for performance programs--with spending rising to $189 million in the state. …

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Today's earnings announcements from health plans and insurers don't look too bad. WellPoint reported a 20 percent surge in profits yesterday, a gain that the company attributes to an increase in membership and decreased medical costs. Aetna also posted good earnings, with first quarter profits up 3.2 percent, but reported a first quarter medical cost ratio of 79.4 percent in its main commercial business. That was up from 77.9 percent a year earlier. Meanwhile, PBM Express Scripts had …

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> The Tenet Shareholder's Committee emailed evidence that suggests that Louisiana AG Charles Foti's investigation of the company's role in the deaths at Memorial Medical Center is still ongoing. Blog

> Colorado lawmakers rejected a law that would have required PBMs to open their books and disclose ownership interests. …

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After years of excellent numbers, some critics are starting to wonder if things are about to take a turn for the worse at UnitedHealth. Goldman Sachs analyst Matthew Borsch reiterated his underperform rating for the company this weekend. Borsch says problems at recently acquired PacifiCare, "market noise on deteriorating customer service" and questions about corporate governance are "red flags" that should not be taken lightly. Borsch notes that PacifiCare earnings in California have …

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More encouraging news about ePrescribing this morning as the Henry Ford Health System (and its subsidiary Health Alliance Plan) is trumpeting its successful implementation of a system backed by PBM giant Medco and the big auto makers. As expected, ePrescribing reduces medical errors and increases the use of generics (and hence lowers drug costs for payers). That's why ePrescribing is …

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This week the most convoluted program in the history of Medicare began. I've heard comments from friends, neighbors and people in the press saying that they can't make heads or tails of the new drug benefit.

Whether you like it or loathe it, there are some interesting parts of the Medicare Modernization Act, including the HSA provision and the disease management provisions. …

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