PBMs: Power brokers in the prescription drug world
A recent legislative hearing in Atlanta featured a stream of PBM critics. South Georgia pharmacist Nikki Bryant said PBMs are putting her out of business. Cancer patient Katie Groover said they have “exhausting” bureaucratic processes that “take away patient choice.’’ Dr. Melissa Dillmon, a Rome oncologist, said PBMs often cause... Read more
Feds seek more data on state’s insurance waiver
Federal officials are asking Georgia for more information on the state’s request for a waiver to make changes to the health insurance exchange. In a letter dated Thursday to Gov. Brian Kemp, the federal Centers for Medicare & Medicaid Services (CMS) indicates that the “reinsurance’’ part of that waiver... Read more
Could federal Medicaid idea reshape Ga. waiver?
A new federal initiative on Medicaid could wind up altering Georgia’s waiver proposal on extending coverage to low-income adults. The Trump administration said Thursday that it’s encouraging states to seek a cap on federal Medicaid funding for covering working-age adults, in exchange for more state autonomy in running that... Read more
Surprise billing, maternal mortality, PBMs: Lawmakers talk health care agenda
A key state senator said Tuesday that he is optimistic a compromise plan on easing the problem of surprise medical billing will finally pass the Georgia General Assembly this year. Sen. Ben Watson (R-Savannah), who chairs the Senate Health and Human Services Committee, told a breakfast gathering that the... Read more
Gainesville-based health system, Anthem finally reach contract deal
Three months after their previous contract ended, Northeast Georgia Health System and Georgia’s largest insurer reached an agreement Monday on a new deal that restores network status to thousands of consumers. The long-running contract dispute had attracted the interest of major state lawmakers and had unnerved many patients of... Read more

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