NEWS AND UPDATES
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Simpara is announcing that four of their esteemed clients will be honored by Health Rosetta Institute for providing employees one of “America’s Top 50 Health Plans.”
Our Humira-Watch continues as a flood of biosimilars hit the market. Some of these drug options cost 85% less than Humira.
While Americans are enjoying the long holiday break the first interchangeable Rx for Humira quietly launched July 1, 2023 - this means the pharmacy can dispense Cyltezo, the cheaper biosimilar, without a new script.
In a quiet announcement last week, CMS issued a new set of FAQs related to Gag Clause Prohibitions – a provision included in the Consolidated Appropriations Act of 2021.
Amjevita, the first biosimilar competitor to Humira hit the U.S. market at the end of January. Showcasing the dysfunction of our healthcare delivery system, the copycat drug came to market with two drastically different list prices. One, a mere 5% discount relative to Humira and another with a 55% discount. Why two prices and who would pay for the more expensive option?
The Department of Labor gave employers an early Christmas gift last week by issuing a new set of FAQs related to the Consolidated Appropriations Act (CAA) and specifically the new health plan reporting requirements.
We’re hearing rumors from industry insiders that the OMB is set to issue regulations which aim to fix the so-called ACA “Family Glitch” as soon as this coming week. The new rules could take effect as early as November 1, 2022 - just in time for Open Enrollment 2023.
For middle-aged men, 1 in 4 suffers from Obstructive Sleep Apnea (17% for women). The average cost for an in-lab sleep study, used to determine and diagnose sleep apnea is $5,384. A high price tag for a diagnosis which may turn up negative.
In 2003, a little drug named Humira hit the market under the name DE27. Analysts believed at the time that Humira, which was approved to treat Rheumatoid Arthritis, would eventually generate between $500M and $1B in sales annually. In 2021, Humira’s global sales totaled $20.7B. Lifetime earnings have eclipsed $200B.
Last week, the Supreme Court made their decision in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., resulting in a 7-2 vote against the major dialysis provider.
Starting in July 2022, the nation’s three largest credit bureaus – Equifax, Experian and TransUnion – will be removing nearly 70% of medical debt in collections accounts from credit reports.
On April 12, 2022, True Captive Insurance will be hosting The Future of Business & Benefits – St. Louis event at Busch Stadium, where local business leaders will discuss employee healthcare trends, self-funding health plans and how to gain control of healthcare spend.
Companies enhancing patient access to care and lowering patient costs all while slashing their own costs? That’s what earns Health Plan Hero status.
The latest in the string of ongoing lawsuits involving opioids has the epidemic making headlines once again. And industry experts like Health Rosetta co-founder Dave Chase share strategies for addressing it once and for all.
We were recently asked what Benefits Reimagined means to us…
Benefits Reimagined means that someone uninsured can get their insulin delivered overnight for free. It means an expecting mother can deliver their child and not worry about affording their deductible because there isn’t one to pay. It means that a woman battling cancer can get the clinical care she needs without having to fight the insurance system that is working against her.
Billionaire investor and Dallas Mavericks owner Mark Cuban enters the pharmaceutical arena in a big way with the launch of the Mark Cuban Cost Plus Drugs Company (MCCPDC), a low-cost online pharmacy for generic drugs
The IRS and Social Security Administration have already announced key dollar amounts necessary for 2022 benefit plan administration. In addition, the IRS has issued the optional standard mileage rates.
Now is a great time to get to know these new numbers and consider what benefits deserve a place in your 2022 plan.
The Departments of Labor, Health and Human Services, and the Treasury jointly issued an FAQ recently to provide guidance for health plans and health insurers on how to reimburse for over-the-counter COVID-19 tests.
The Supreme Court on Thursday blocked the Biden administration from enforcing a vaccine-or-testing mandate for large employers, dealing a blow to a key element of the White House’s plan to address the pandemic as cases resulting from the Omicron variant are on the rise. But the court allowed a more modest mandate requiring health care workers at facilities receiving federal money to be vaccinated.
Friday, December 17th the 6th Circuit Court of Appeals lifted a stay on the Biden administration rule - requiring workers at companies with 100 or more employees to be vaccinated against Covid or undergo weekly testing.
“Ask yourself when the last time was your doctor personally called you just to ask how you are?” said Mia, a Link Primary Care member. “Mine does regularly.”
Mia is one of many who’ve opted for a non-traditional primary care option like direct primary care (DPC) or concierge care. What was once considered “luxury medical care” and came with a price tag to match, is now becoming more accessible and, in our rapidly changing world, more essential.
When health plans adopt high-value primary care, the biggest impact is healthcare that employees learn to love. It’s fairly simple: Healthcare that fits your life, A personal doctor who knows you, Access when you need it, and Never any copays or deductibles.
As companies continue to develop – and pivot – their strategies for successfully and safely bringing employees back into the office, one thing some have turned to is the implementation of a COVID-19 vaccine requirement as a condition of employment.
This week, the U.S. Equal Employment Opportunity Commission (EEOC) addressed questions about the religious implications of such requirements and how they interact with federal equal opportunity (EEO) laws.
To help ensure there are “no surprises” when the No Surprise Act goes into effect, we’re taking a closer look at the latest rule, what it means, and some potential consequences.
MLR premium rebate checks began mailing this month and those who qualify are expected to receive their check for the 2020 plan year by the end of the month.
For benefit health plan 2020, UnitedHealthcare’s results show 53 group aggregation sets – 23 small group and 30 larger group – are qualified to receive premium rebates totaling $141,754,976. Additionally, 6 individual aggregation sets are qualified to receive rebates totaling $3,667,822.
Hidden no more. The Employers’ Forum of Indiana (EFI) is giving people a look behind the curtain at the reality of hospital costs in the United States.
What began as the first hospital price transparency study in the U.S., commissioned by EFI and conducted by RAND Corporation back in 2017, eventually became the foundation for the Employer Hospital Price Transparency Project.