Medicaid

cost avoidance prescription drug costs Syrtis Solutions

28 Feb STATES TAKE ACTION TO REDUCE MEDICAID PRESCRIPTION DRUG COSTS

In 2018’s legislative session, 45 laws were passed by 28 states to address the problem of prescription drug costs. Apart from these legislative efforts, administrative actions are also being taken to improve the management of Medicaid pharmacy benefits spending. Ohio, West Virginia, and California are...

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CMS

23 Jan MEDICAID IN 2019

Last year, there were multiple attempts to reform the Medicaid program. While efforts at the federal level met resistance, multiple reform initiatives took place at the state level.  These measures included legislation, program expansion, demonstration waivers, eligibility restrictions, and work requirements. Some of these changes...

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17 Jan EXECUTIVE ORDER: MEDI-CAL TO NEGOTIATE DRUG PRICES

California’s newly elected governor; Gavin Newsom (D) has recently made a legislative step to address skyrocketing drug prices. Shortly after he was sworn in last week, Newsom signed an executive order making the state responsible for negotiating drug prices directly with pharmaceutical companies. In addition,...

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ACA Supreme Court Texas Medicaid Syrtis Solutions

20 Dec TEXAS JUDGE RULES THE ACA UNCONSTITUTIONAL

The future of the Affordable Care Act (ACA) is in jeopardy after a federal district court judge ruled the law unconstitutional. On Friday, Judge Reed C. O’Connor (TX) sided with twenty Republican legislators and ruled the law unconstitutional after congress passed the December 2017 tax bill. Last years...

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Syrtis Solutions Improper Payments CMS Trump

26 Oct PREVENTING IMPROPER MEDICAID PAYMENTS

Of the $4 trillion spent by the government in 2017, nearly $141 billion were improper payments. These are payments made in error either to the wrong recipient, in the incorrect amount, or for a service that is not legitimate. Fraud, antiquated data systems, and methodologies...

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09 Oct HEALTHCARE MEGA-MERGERS

Over the last year, there has been a wave of PBM and healthcare provider mega-mergers. These acquisitions have undergone intense review and the approvals suggest that government regulators are more comfortable with vertical integration as opposed to horizontal. Here is an overview of these mergers. CVS...

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