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»  Posts By   May 2015 

Biosimilars: Good or Bad For Independent Specialty Pharmacies?

The recent developments in the Biosimilar marketplace are potentially positive for pharmacies able to acquire and bill for biosimilars and navigate complex State regulations. Increased competition in biologic products is expected to improve availability and lower acquisition costs for specialty pharmacies, bolstering their bottom line and providing patient choice of drugs and pharmacies. But first, what are biosimilars? While most drugs are chemical compounds that are easily copied by generic...

Tricare Issues Alert to Beneficiaries Regarding Call Centers Seeking Compounded Prescriptions

The Defense Health Agency, the Agency that oversees Tricare, issued an alert to Tricare beneficiaries warning them of call centers targeting Tricare beneficiaries through unsolicited calls seeking compounded prescriptions. The alert indicated that the Defense Health Agency, Office of Program Integrity (DHA-PI) has received a significant number of complaints from Tricare beneficiaries regarding unsolicited attempts by “Call Centers” to encourage them to provide personal identifying information and health information so...

UnitedHealth Ramps Up Coverage of Video Doctor Visits

UnitedHealthcare, the largest private insurer in the United States, has announced that it will provide coverage for telemedicine to its self-funded employer customers. In partnering with three telemedicine providers, UnitedHealth is offering its insured 24-hour video access to licensed and qualified physicians in their state. The insurance company will pay a portion of a valid video conference, which is typically up to $30 less than an in-person visit. The remaining...

Express Scripts’ Specialty Pharmacy Accredo Health Group Will Pay $60 Million to Settle Kickback and False Claim Allegations

Accredo Health Group, a specialty pharmacy run by Express Scripts, has agreed to a $60 million settlement to resolve allegations by the United States Department of Justice (DOJ) that the company participated in a kickback scheme with Novartis to induce specialty pharmacies to boost prescriptions for certain drugs. Approximately $45 million will paid to the United States and approximately $15 million will be paid to a group of states to...

Office for Civil Rights Settles with an Independent Compounding Pharmacy Violations of HIPAA Rules

On April 22, 2015, the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced a $125,000 settlement with a single location pharmacy to resolve potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). OCR initiated a compliance review and investigation of Cornell Prescription Pharmacy after receiving notice from a third party that the Pharmacy improperly disposed of documents containing the unsecured Protected...
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