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Managed Care May 2007 Martin Sipkoff	Medication Therapy Management May Finally Enter the Mainstream Pharmacies can now take advantage of CPT codes to bill insurers for direct patient care. Will private payers follow Medicare in offering this service?
Managed Care October 2007 Martin Sipkoff	Asheville's Legacy: Pharmacy Moves From Dispensing to Clinical Management It is an idea whose time has finally come: Today's clinical pharmacists are involved in virtually all aspects of medical care.
Pharmaceutical Executive October 1, 2005 Phil Patrick	Marketing to Professionals: Senior-Care Specialists Surge In light of the growing senior population, pharmaceutical marketers are building partnerships with senior specialists.
Managed Care May 2004 Thomas G. Dolan	Pharmacist Care An Idea Whose Time Is Still Coming For more than a decade, it has seemed this idea would catch fire. But many insurers are still looking for evidence that it can reduce overall costs.
Managed Care January 2008 Martin Sipkoff	Should Pharmacists Be Allowed To Vaccinate Their Patients? Although federal health agencies support the idea of having pharmacists administer vaccines to their patients, the roadblock continues to be a question of payment.
Managed Care June 2005 Martin Sipkoff	MMA Formulary Design Requires Health Plans To Control Costs Despite a mandate to adopt utilization management programs and make patients share costs, health plans are still lining up to participate in Medicare Part D.
Managed Care October 2001 Patrick Mullen	Interview: Pharmacists in Need The executive vice president and CEO of the American Pharmaceutical Association says pharmacists are being inundated and need help...
Pharmaceutical Executive April 10, 2014	Obama Policies Reshape Pharma Marketing Health reform initiatives promote transparency, challenge reimbursement, writes Jill Wechsler.
Pharmaceutical Executive November 1, 2006 Mike Mallett	Marketing to Professionals: Penetrate the Point of Purchase Leverage mystery shoppers, and improve patient compliance through local pharmacists.
Pharmaceutical Executive June 1, 2014 Ben Comer	Take as Directed: From Force to Finesse in Promoting Adherence Healthcare players tout patient education and engagement as the keys to better drug adherence rates. Patients agree, as long as that translates to convenient and affordable access to therapy.
Managed Care February 2002	Computer Glitch Blocks Too Many Prescriptions Pharmacists in Massachusetts were hopping mad when a new computer system designed to help process prescriptions for Medicaid enrollees malfunctioned during its launch...
Managed Care February 2006 Martin Sipkoff	Don't Bet That Problems With Part D Are Over Medicare Part D enrollment snags could be just the start of political and regulatory headaches facing health plans and pharmacy benefit managers.
Pharmaceutical Executive December 1, 2011 William Looney	The Medicines Adherence Challenge Keeping skittish patients on their medicines ought to be a strategic priority for Big Pharma, but is it? An expert round table examines how best to make progress and agree on some practical steps for incorporation in the campaign agenda.
Pharmaceutical Executive March 1, 2013 Ken Getz	Building Clinical Trial Awareness for Patients: Why Not Try the Pharmacist? The author explains how building a stakeholder outreach agenda around the community pharmacist can lead to a better outcome in managing the complex ins and outs of a trial protocol.
Pharmaceutical Executive June 1, 2005 Jill Wechsler	Washington Report: "D" Is for Data It is critical for Medicare to address important questions on drug safety and utilization, and about how prescribing decisions affect health outcomes and costs.
Pharmaceutical Executive August 1, 2013 Jill Wechsler	Costs and Coverage Challenge Medicare Drug Plans Rate cuts and fraud concerns create problems for Part D plans and Part B providers.
Managed Care November 2005 Martin Sipkoff	Confusion Rules the Day As Medicare Part D Begins With a dizzying array of coverage possibilities, there is a strong possibility that some people who would benefit will fail to enroll in any plan.
Pharmaceutical Executive February 1, 2006 Jill Wechsler	Washington Report: Cross-Agency Collaboration for Part D Medicare Part D gives CMS more clout over coverage, pricing, and even drug development.
Managed Care March 2007	Use of Generics On the Rise Recent data indicate that generic medication accounts for nearly 60% of the drugs dispensed to people in Medicare Prescription Drug Plans and Medicare Advantage plans.
Managed Care August 2001 Patrick Mullen	The Expanding Role of Pharmacists Lobbying in Washington, monitoring state legislation and generally looking out for the interests of pharmacy programs run by health care plans and pharmacy benefit managers, Judith Cahill leads the Academy of Managed Care Pharmacy at an exciting, critical time...
Managed Care February 2002 Bob Carlson	Proposal To Regulate Formularies Draws Sharp Difference of Opinion The National Association of Insurance Commissioners has spent two years developing a model. Drug companies like it; health plans don't...
Pharmaceutical Executive August 1, 2005 Kevin Barnett	Part D Phase 2 Pharmaceuticals have been scrambling to get their Medicare contracting in order. Now it's time to figure out part D marketing and sales. Here's a checklist for the months ahead.
Pharmaceutical Executive September 1, 2013 Shantanu Agrawal	Making Sense of the Sunshine Act: A New Era for Drug Promotion Now that the Sunshine Act's Open Payments spending disclosure program is live, the federal government's lead officer for compliance explains how the new web-based system will work and how US industry, providers, and patients will be better off by making their relationships fully transparent.
Pharmaceutical Executive February 1, 2014 Jill Wechsler	Drug Coverage, Costs Under Scrutiny Benefits offered by insurance plans on health exchanges and through Medicare are raising concerns about patient access to needed therapies
Pharmaceutical Executive October 1, 2010	Pharmacies are Our Friends An underutilized sales resource, pharmacies and their staffs can help lead to improved scrip fulfillment and increased business.
Managed Care October 2001 Michael Levin-Epstein	Medicare Demonstration Projects Seek To Coordinate Chronic Care The Centers for Medicare and Medicaid Services is awaiting the results of landmark demonstration programs to determine if improved Medicare services can be furnished to chronically ill patients without increasing costs...
Managed Care December 2002	M+C meltdown hinders access to medications The fact that health plans are abandoning Medicare+Choice at a slower rate than in previous years doesn't mask the fact that the exodus of plans only exacerbates the problem of lack of pharmaceutical coverage for the elderly.
Managed Care October 2001 Michael Levin-Epstein	Medicare+Choice Reform: Hope, but No Quick Action Expected There have been small accomplishments, and wheels have been churning for more forceful action -- that is, they were until Sept. 11...
Managed Care February 2005	Medicare's Drug Coverage Seeks To Strike Compromise Health plan officials are still trying to determine just how the final rules for the new Medicare prescription drug benefit will affect them, because it appears that government officials tried their best to address the competing concerns of all players.
Managed Care January 2008 Marcia Naveh	Lax Coding by Physicians Hurts Medicare Advantage Plans By assisting doctors, insurers can get all the payment that they are due, but that too often is lost.
Managed Care July 2004 Maureen Glabman	Wish List: 10 Things You Want From Your PBM One auditor estimates that 3 percent to 10 percent of pharmacy benefit manager (PBM) claims are processed incorrectly -- always in favor of the PBM.
Managed Care May 2005 Martin Sipkoff	Health Plans Undaunted By Medicare Part D Despite the seeming Gordian knot of regulations associated with Medicare Part D, health plans figure the benefit-to-risk ratio is squarely in their favor.
Managed Care March 2006 Taylor & Eck	It's Time for CMS to Release Physician Medicare Claim Information The Center for Medicare & Medicaid Services is a rich source of price and quality data. Isn't it about time it shared that data?
Pharmaceutical Executive December 1, 2006 Rod Cavin	Forecasting Medicare: Price Controls in the Years Ahead Part D in 2010 will be under price and access pressure. Pharma should develop plans for the future by imagining best- and worst-case scenarios.
Pharmaceutical Executive May 1, 2014 Jill Wechsler	Reimbursement Limits Threaten Drug Access High cost-sharing, narrow formularies create problems for pharma companies and patients.
Pharmaceutical Executive November 1, 2005 Rubinstein & Galardi	Bustin' a CAP: The Competative Acquisition Program The new Competitive Acquisition Program for Medicare Part B drugs aims to align market forces with the distribution of drugs and biologics that doctors administer in their offices, but increasing bureaucracy is a major downside.
Inc. September 2007 Bobbie Gossage	How I Did It: Charles Hallberg, Founder and CEO, MemberHealth How Charles Hallberg turned a 13 person company into a $630 million business.
Pharmaceutical Executive May 1, 2006 Huang, Pesile & Mozeson	Medicare Part D: D for Doomed? New drug coverage plans cost more money and serve fewer patients than the government expected. What if things get worse? Here are two scenarios for disaster.
Managed Care December 2001 MargaretAnn Cross	Increased Pressures Change P&T Committee Makeup Formulary committees once were stocked with academics and administrators. Today, primary care physicians, specialists, and retail pharmacists play a bigger role, and tomorrow's membership will be even more diverse...
Managed Care April 2002 Rhonda Greenapple	HMOs Have Stake in Quelling Anger at Drug Store Counters Dissatisfied customers have a tendency to lash out and not be very discriminating about their targets. Prescription: Reduce the hassle...
Managed Care April 2005	Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation.
Managed Care September 2006 Martin Sipkoff	PBMs Raise the Curtain Efforts are under way to find out exactly how pharmacy benefit managers work their magic.
Managed Care April 2005 Frank Diamond	Starting Medicare Advantage Plan Brings Special Set of Problems The feds will help you launch a health plan for the elderly, but just what does it take to get something like this operating in so short a time?
Pharmaceutical Executive April 1, 2007 Jill Wechsler	Washington Report: Medicaid Sets the Pace for Pharma Pricing Forget Medicare price negotiations. Pending changes in Medicaid drug-pricing formulas will put even more pressure on pharmaceutical prices.
American Family Physician September 15, 2006 Liz Smith	Newsletter CMS Issues Guidance on Part D vs. Part B Coverage Determination... Residents, Students Adopt Resolutions on Drug Samples, Universal Care... CMS Proposes Changes to Outpatient Services Policies and Payment... etc.
Managed Care May 2002 Frank Diamond	Medicare+EvenMoreChoice: U.S. Encourages PPO Option The government offers financial incentives that include $100,000 in seed money, risk-sharing deals, and higher payment rates
The Motley Fool September 1, 2010 Brian Orelli	Dendreon: One Step Closer to Worry-Free Back in July, the Centers for Medicare & Medicaid Services announced that it planned on reviewing the reimbursement for Dendreon's prostate cancer treatment Provenge.
Job Journal August 21, 2005 Julia Hollister	As America Ages, Pharmacists Flourish Demand for more druggists is swelling as baby boomers age. According to Department of Labor statistics, the outlook for employment is excellent and that trend is expected to continue for at least the next seven years.
Pharmaceutical Executive July 1, 2014 Jill Wechsler	Pre-emption and States' Rights Pharma backs federal standards for compassionate use, drug importing, data transparency, and track-and-trace.
Pharmaceutical Executive July 1, 2006 Jill Wechsler	Washington Report: Hard Evidence The push for more useful information on medication effectiveness is shaping drug development and reimbursement.