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March 7th, 2006 - CMS Directs Drug Plans to Expedite Coverage Decisions

To ensure that Medicare patients have uninterrupted access to medically necessary prescription drugs, the Centers for Medicare & Medicaid Services (CMS) has directed all Part D prescription drug plans to expedite coverage decisions for Medicare beneficiaries. The plans must make and communicate coverage decisions within 24 hours for an “expedited” request and 72 hours for a standard request. More...

March 7th, 2006 - OHIO JURY FINDS MEDCO DEFRAUDED RETIRED TEACHERS; NCPA APPLAUD VERDICT

The National Community Pharmacists Association (NCPA) applauded the verdict of an Ohio jury, when it decided that the giant pharmacy benefit manager (PBM) Medco Health Solutions Inc. should pay $7.8 million to the State Teachers Retirement System of Ohio (STRS Ohio) for breaching its fiduciary duty and for fraud.  More...

March 7th, 2006 - Medco could soon find out that cheap cures don't always last
Until recently, the giant pharmacy benefit manager had expected to pay $42.5 million to settle a major class-action lawsuit. But an appeals court ruling will force a federal judge who presided over the case to re-examine the deal, raising the prospect that the settlement could collapse.  More...

November 28th, 2005 - When Health Insurance Is Not a Safeguard
Until the fourth trip to the hospital in 1998, Zachery Dorsett's parents thought their son was an average child who was having trouble getting over a passing illness. He was 7 months old, and it was his second case of pneumonia. More...