Tag Archives: Restricted Networks

Happy Birthday Medicare and Medicaid.  It’s been 50 years since President Lyndon Johnson signed the bills into law, and my, how they have grown! Currently, 35% of all U.S. residents receive their healthcare through these programs and $4 out of  every $10 spent on healthcare dollars channel through  Uncle Sam. (These numbers will continue to […]

Six independent pharmacies in Texas have decided to sue CVS Caremark under the Racketeer Influenced and Corrupt Organizations (“RICO”) Act, charging that the company’s Caremark pharmacy benefits management (“PBM”) division engaged in racketeering and violated HIPAA by gaining control over patient data and eliminating competition out of the retail pharmacy market. Pretty heavy stuff when the RICO card gets played! […]

Never let it be said that Walmart doesn’t know marketing. In the aftermath of the CVS/Caremark/Walgreens turf battle, where the question of adequate member access was raised (Networked),  Walmart jumps right back into the frey and releases their low-price network option.  They are referring to it as *Access Based Network Design* and are touting it […]