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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 December 2007	Insurers Offer More Coverage to Fill Part D Gap Filling the gap in coverage in which the enrollee pays 100% of total drug costs before catastrophic coverage begins will be a significant issue that stand-alone Prescription Drug Plans and Medicare Advantage Prescription Drug plans face in 2008.
Managed Care December 2006 Martin Sipkoff	Federally Negotiated Drug Prices Anticipated for Medicare Part D Congress to force the issue of federally negotiated drug prices. This could eventually lead to a government-run drug plan.
Managed Care January 2007	Seventy-Five Percent of Cancer Drugs Covered Under Medicare Part D Seventy-five percent of cancer drugs are covered by Medicare Part D plans, with regional Medicare Advantage prescription drug plans covering 85 percent.
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 February 2007 Martin Sipkoff	What's Good for the VHA Is Not So Good for Medicare Fundamental differences in program structure between Medicare and the Veterans Health Administration make drug pricing negotiations problematic.
Managed Care February 2006	For Drugs, the VA Pays Far Less Than Medicare A recent survey indicates that prices for the top 20 drugs used by Medicare enrollees are much higher than prices negotiated by the Department of Veterans Affairs.
Managed Care December 2007 Martin Sipkoff	Large Plans Do Well Under Part D, But Premium Hikes Cloud Future Profits should increase over the next two years for plans that stay the course, but politics and rising premiums may affect long-term results.
Managed Care March 2002	How Medicare beneficiaries spend money on drugs The Kaiser Family Foundation notes that Medicare beneficiaries account for 14 percent of the U.S. population, but for 43 percent of the nation's spending on prescription drugs. Thirteen percent of beneficiaries had to pay $2,000 or more out of pocket in 2001...
Registered Rep. October 13, 2011 Mark Miller	Determining Your Elderly Clients' Best-Fit in Medicare Plans You may be able to help senior clients save thousands of dollars in out-of-pocket health care costs by encouraging them to comparison shop for Medicare prescription drug and managed care options during the program's annual fall enrollment season.
Managed Care October 2007	The Formulary Files Retirees stop taking drugs when annual benefit runs out.
Managed Care December 2002	Drug-discount program's effectiveness hindered by lack of use California offers a prescription drug discount program that allows Medicare beneficiaries to get discounts just by showing their Medicare cards to pharmacists. Unfortunately, a majority of those eligible -- both those with and without drug coverage -- have never heard of the program.
Managed Care January 2008	Copayment Rates Outpace Inflation Workers are definitely paying more for health benefits today than they were in 2000, especially for prescription drug copayments.
Managed Care July 2002	Memo Clarifies CMS Guidelines on Injectables Injectable drugs should be covered by Medicare if beneficiaries administer them less than 50 percent of the time, according to a clarification on this issue by the Centers for Medicare and Medicaid services that's set to take effect Aug. 1.
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.
The Motley Fool August 18, 2006 Dan Caplinger	The Medicare Drug Dilemma: Part 1 Seniors have a great benefit available to them, but it's tough sorting through it all. We're here to help.
Managed Care July 2006	Public Payers Foot Greater Pharmacy Costs Through 2005, private health insurance had covered most of the cost of prescription drugs. That picture is changing as public payments, mostly under Part D, are projected to exceed private health insurance and out-of-pocket payments.
The Motley Fool January 22, 2007 Michael P. Cecil	Will Medicare Negotiate With Drug Companies? One of the bedrock principles of our economic system is that those buying more of a product receive a discount. Wouldn't empowering Medicare to save taxpayers' money be widely embraced as a great idea? But how would pharma investors see it?
Managed Care March 2004	More Retirees Face Life Without Health Benefits Employer-sponsored health benefits for retirees could go the way of house calls and dial phones thanks to increasing health care costs. A study says that 10 percent of 408 companies with 1,000 employees or more plan to drop coverage for future retirees.
Managed Care February 2007	Managed Care Outlook Coverage for children leads policy debate.
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 March 2006	The Formulary Files Four or more tiers that are common among PDPs and MA-PD plans.
Registered Rep. October 10, 2014 Mark Miller	Healthcare Inflation is on the Mend Tame healthcare inflation is good news for your retired clients.
Managed Care December 2004	Number of Prescriptions Grows Faster Than Population With the rising costs of prescriptions and other issues relating to implementation of the new Medicare drug benefit, it is no wonder that policymakers are considering new approaches to addressing drug costs.
Registered Rep. November 1, 2005 Lynn O'Shaughnessy	Medicare Drug Benefit 101 If financial advisers can understand the basics of the new Medicare drug benefit plan, they can provide a great service to their clients -- perhaps even save them money in premiums. Here's where to start.
Managed Care March 2006 David Adler	Tiers Reach New Heights Under Part D Can commercial health plans learn from Medicare Advantage Prescription Drug Plans that have four or more formulary levels?
Managed Care August 2004 Martin Sipkoff	Bad Tiered Formulary Designs Yield Poor Outcomes, High Cost Now that tiered formularies rule the land, what many suspected is being demonstrated: Compliance is suffering and so, too, are patients.
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
The Motley Fool August 18, 2006 Dan Caplinger	The Medicare Drug Dilemma: Part 2 What happens when you need to make a change to your Medicare prescription plan? We'll help you figure it out.
Managed Care March 2005	ED drugs covered, but managed care unmoved Health care insurers account for the coverage of erectile dysfunction drugs.
Managed Care May 2005	Implementing Medicare Part D Could Get Ugly This expert who hopes to help everybody adjust, nevertheless expects big headaches come Jan. 1, 2006. However, e-prescribing could make the drug plan work.
Managed Care July 2005	Seeing is believing? Medicare reform seems to be taking root.
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 March 2004	More State Medicaid Programs Use Preferred Drug Lists To Manage Costs Medicaid, enacted in 1965, is currently costing over $200 billion per year. With rapidly rising health care costs, including prescription drugs, state Medicaid budgets are feeling the strain. Here's what they're trying to do to manage.
Managed Care February 2007	Medicare Part D Cost Increase Estimate Lowered Net Medicare Part D costs for fiscal year 2008 are estimated to be 30 percent less than projected when the benefit was created back in 2003.
Managed Care March 2002	M+C Enrollees Bound to Their Choice Until June A lock-in mechanism for Medicare+Choice that kicked in Jan. 1 narrows the period during which enrollees can switch from health plan to health plan...
Managed Care July 2005	Cost being equal, consumers prefer older drugs Seven out of 10 consumers would prefer a drug that had been on the market for 10 years or more, compared to a newer drug, even if the copayments were equal. This could be a sign that consumers are more inclined to start using generic medications.
Managed Care June 2006 Martin Sipkoff	Limiting Access to SSRIs Does More Harm Than Good Despite the higher costs of SSRIs, compared to older antidepressants, limiting members' access can lead to undertreated depression.
Managed Care September 2007	Ninety Percent of Adults Eligible For Medicare Have Drug Coverage A study from the University of Michigan Institute for Social Research finds that 90 percent of Americans age 65 and older now have prescription drug coverage, compared to more than 75 percent who were covered in 2004.
Financial Planning February 1, 2006 Janet Aschkenasy	Drug Deals Here is how to help your financial advisory clients make sense of Medicare Part D.
Managed Care July 2000 Michael Levin-Epstein	Congress Asked To Take Action As HMOs Flee Managed Medicare Thanks mainly to the increasing cost of providing a prescription drug benefit, HMOs are exiting Medicare+Choice, the system that was supposed to manage the health of the nation's senior citizens, in droves. Only an act of Congress can save Medicare+Choice, but is seems doubtful that will happen.
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 May 2001	Old Ideas About Formulary Structure Gone as Humana Tests 4-Tier Model Humana is phasing in a four-tier formulary that categorizes prescription drugs by costs, rather than generic or brand status. The higher the drug's acquisition cost -- regardless of whether it's a branded or generic product -- the higher the tier it lands in...
Managed Care August 2001 Steve Perlstein	Four-Tier Approach Injects Consumerism Into Drug Benefit In tying copayments closely to the actual cost of medications, Humana takes a step toward promoting awareness of resource use...
The Motley Fool December 12, 2006 Dan Caplinger	Don't Fall Into the Doughnut Hole Medicare Part D provides valuable benefits for seniors. However, because the doughnut hole is a gap in coverage by prescription-drug plans, seniors must be prepared to deal with the costs associated with it.
Pharmaceutical Executive October 1, 2008 Jill Wechsler	Part D Under Attack Congressional leaders ready campaign to curb Medicare drug plans.
Managed Care November 2004 John Carroll	Medicare Formulary Model Seen by Many as Too Inclusive The issue is how extensive the list of covered medications should be for the new Medicare pharmaceutical benefit. The stakes are enormous.
Pharmaceutical Executive November 1, 2005 Jill Wechsler	Washington Report: Out of Commission? Crawford Steps Down The clouded circumstances of the commissioner of the Food and Drug Administration may complicate the process of securing a permanent leader. Meanwhile, battles continue over hot-button issues such as the morning-after pill and the regulation of follow-on biologics.
BusinessWeek May 1, 2006 Howard Gleckman	Medicare Surprise Why many seniors could temporarily lose drug coverage.
InternetNews October 13, 2004 Roy Mark	Report: The Internet and Drugs Don't Mix It seems an increasing number of Americans are researching drugs online, but safety fears chill buying.