On August 20, 2020, Humana Pharmacy Solutions, Inc. (“Humana”) filed a lawsuit alleging, among other things, violations of the Racketeer Influenced and Corrupt Organizations Act (“RICO”) against a Florida-based company, Quivvy Tech Corp.,... Read More
In an effort made in response to the COVID-19 emergency thus far, as previously discussed in our posts, “What Are the PBMs Doing Amid COVID-19 Crisis: Waivers from Strict Requirements May Exist for Independent Pharmacies,” and “UPDATE: Humana... Read More
As previously discussed in our post, “What Are the PBMs Doing Amid COVID-19 Crisis: Waivers from Strict Requirements May Exist for Independent Pharmacies,” many healthcare companies alike are taking further actions to ensure that patients have... Read More
The Centers for Medicare & Medicaid Services (CMS) recently announced a final rule allowing Non-skilled in-home care services as a supplemental benefit for Medicare Advantage (MA) plans in 2019. This is first time CMS has allowed supplemental... Read More
While PBMs have scrutinized retail pharmacies for mailing activities for some time, over the last several weeks, several major PBMs have embarked on renewed tactics aimed at clamping down on pharmacies dispensing prescription medications to their... Read More
According to the 2015 Form 10-K filed by the drug manufacturer Insys Therapeutics, Inc., Humana began sending letters to its participating pharmacy providers in January 2016 "indicating that as a result of a CMS audit, Humana was initiating a... Read More
In April 2016, pharmaceutical company Warner Chilcott was sentenced to pay $125 million for its role in allegedly providing kickbacks to prescribing physicians as well as its submission of false, inaccurate, or misleading prior authorization... Read More
This past week, Humana announced a 46% decrease in profits stemming largely from the costs associated with the ongoing Aetna merger, which is anticipated to close in the second half of 2016. As part of the transaction, Aetna is set to acquire... Read More
Recently, there have been two significant proposed mergers between large health insurance companies – the acquisition of Humana Inc. by Aetna Inc., and the acquisition of Cigna Corp. by Anthem Inc. Significantly, these mergers would result in 42%... Read More
On October 19, 2015, Aetna Inc. and Humana Inc. announced that their respective shareholders had approved Aetna's proposed acquisition of Humana, which was originally announced on July 3, 2015. Pursuant to the proposed acquisition, Aetna will... Read More