HHS faces new challenges in running health insurance exchanges | States, commissioners compile exchange questions | Medicare policies promote risky compounding, critics say
November 20, 2012
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HHS faces new challenges in running health insurance exchanges
More states than expected are declining to set up health insurance marketplaces under the Affordable Care Act, leaving HHS with a larger role than the Obama administration envisioned. HHS must ensure information technology systems work with aging state Medicaid systems, confirm health plans sold on exchanges meet all eligibility requirements and set up appeals processes and call centers. Politico (11/20)
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States, commissioners compile exchange questions
A committee of the National Association of Insurance Commissioners is compiling a list of questions for HHS regarding health insurance exchanges. Iowa Gov. Terry Branstad, a Republican, already submitted 50 questions to HHS asking how exchanges should be set up and run. Kaiser Health News/Capsules blog (11/19)
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Legislative & Regulatory News
Medicare policies promote risky compounding, critics say
Medicare, along with some private insurers, covers nearly all compounded drugs, which could have promoted the rise in large compounders such as the New England Compounding Center at the heart of a nationwide meningitis outbreak, Public Citizen and lawmakers including Sen. Richard Blumenthal, D-Conn., charge. Reuters (11/19)
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PBM Industry News
Drug Industry Spotlight
Dems seek probe into role of group purchasing in drug shortages
Six Democratic members of Congress asked the Government Accountability Office to look into whether hospital group purchasing organizations have had an effect on drug shortages and a greater use of drug compounding. "Increased hospital reliance on compounded drugs should be a result of increased need, not unfair pricing," Rep. Ed Markey, D-Mass., said. The letter suggests "anticompetitive, exclusionary contracts" between the organizations and makers of generic drugs should be examined. Pharmalot/Pharma Blog (11/19)
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A good man with a good conscience doesn't walk so fast."
-- Georg Büchner,
German writer
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About PCMA
PCMA is the national association representing America's pharmacy benefit managers (PBMs), which administer prescription drug plans for more than 216 million Americans with health coverage provided through Fortune 500 employers, health insurance plans, labor unions, and Medicare Part D. PCMA is dedicated to enhancing the proven tools and techniques pioneered by PBMs that generate savings and access for consumers and payors.

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