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2021 Drug Plan Trends Report: Diving deep into the pros and cons of drug pooling

In Western Canada, specialty drugs’ share of private plans’ costs is 23%, due to pharmacare programs in three provinces automatically acting as first payer for prescription drugs after an income-based out of-pocket deductible, climbing to 38% in Atlantic Canada. As much as 60% of the current pipeline is focused on specialty medications, according to a 2020 report from Express Scripts Canada, with about 50% of drugs in the pipeline designed for oral administration, continuing a shift in costs from provincial to private plans. This framework is two-tiered, as a Green Shield Canada report notes each insurer places eligible high-cost drug claims from their fully-insured plans into their proprietary extended health-policy protection plan pools. The pooling threshold, typically upwards of $10,000, is negotiated between plan sponsor and carrier.

Conflicting Corporate Claims At The Heart Of Ohio s Blockbuster Medicaid Suit

Conflicting Corporate Claims At The Heart Of Ohio s Blockbuster Medicaid Suit Patch 1 hr ago Two mega-corporations appear to be claiming they did the same work for Medicaid Ohio’s $24 billion-a-year program that provides health care to the poorest 25% of state residents. Since the companies received at least $53 million for the work in 2017 alone, the conflicting claims could be a big problem one with potential implications in the many states where the companies do Medicaid business. Popular Searches Ohio Attorney General Dave Yost last month filed suit against Centene, the largest Medicaid contractor in the United States, accusing it of charging the state for services it didn’t perform, among other things.

Cigna + Oscar Expands Small Businesses Access to Affordable Health Plans in California

Press release content from Business Wire. The AP news staff was not involved in its creation. Cigna + Oscar Expands Small Businesses’ Access to Affordable Health Plans in California April 8, 2021 GMT NEW YORK (BUSINESS WIRE) Apr 8, 2021 Cigna, a leading global health service company, and Oscar Health, Inc. (“Oscar”) (NYSE: OSCR), the first health insurance company built on a full stack technology platform, today announced that Cigna + Oscar1 small business health insurance will be available in the Bay Area, Central Coast, Greater Sacramento, Inland Empire, Los Angeles, Orange County, North Bay, and San Diego regions. ADVERTISEMENT “Small businesses are the heart of the economy, and of their local communities. Now more than ever, they need affordable health insurance that works for them and their employees,” said Bruce Grimm, Cigna’s senior vice president of segments. “Cigna + Oscar brings together Cigna’s nationwide and local provider networks, and Oscar’s me

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