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Employer stop-loss could break free from state, federal health insurance rules
2+ hour, 8+ min ago (597+ words) The Self- Insurance Protection Act bill could free employers' stop-loss insurance policies from federal health benefits rules as well as from state health benefits mandates, according to analysts at the Congressional Budget Office. Employers with self-insured health plans use stop-loss…...
BCBS Texas lawsuit against Halo MD dismissed
7+ hour, 2+ min ago (459+ words) A federal judge in Texas has dismissed Blue Cross Blue Shield of Texas' lawsuit against Halo MD with prejudice, handing a victory to the health care claims management firm in one of the latest legal battles over the federal No…...
Premiums out of context are a consumer trap
6+ hour, 29+ min ago (21+ words) Benefits PRO Premiums out of context are a consumer trap More From HR Executive...
CVS sues Tennessee over new law barring PBMs from owning pharmacies
2+ day, 4+ hour ago (314+ words) CVS Health serves nearly 1. 5 million Tennessee residents through 136 pharmacy locations, the company said. Tennessee recently enacted a law that prevents pharmacy benefit managers from also owning pharmacies in the state. Late last week, CVS Health filed a federal lawsuit challenging…...
Mark Cuban's Cost Plus Drugs often beats employer plan cost-sharing amounts
2+ day, 12+ min ago (456+ words) The Mark Cuban Cost Plus Drug Company pharmacy often charges prices for prescription drugs that are lower than employer plan cost-sharing requirements for those drugs, according to a new peer-reviewed research paper. Dr. John Lin, a researcher at the University…...
Rethinking benefits: What if we paid members to get healthy?
3+ day, 5+ hour ago (25+ words) Benefits PRO Rethinking benefits: What if we paid members to get healthy? More From HR Executive...
As cost climbs 30%, dermatology drug bills get under plans' skin
3+ day, 2+ hour ago (510+ words) The growing popularity of Dupixent contributed to a 30. 3% increase in commercial health plan spending on dermatology specialty drugs in 2025, according to a new drug trend report from Navitus Health Solutions, a fee-based pharmacy benefits manager. The plans that Navitus tracks…...
Hospital stays, specialty drugs drive high-cost claims
3+ day, 7+ hour ago (21+ words) Benefits PRO Hospital stays, specialty drugs drive high-cost claims More From HR Executive...
Some House Democrats want PBM 'kickback' bill to include all plan service providers
6+ day, 21+ hour ago (74+ words) Benefits PRO Some House Democrats want PBM 'kickback' bill to include all plan service providers What You Need To Know - The PBM Kickback Prohibition Act bill was introduced by Rep. Rick Allen, R-Ga. - The bill would prevent PBMs from paying…...
No Surprises Act dispute resolution services award $1 K for $81 ER visits
1+ week, 1+ day ago (82+ words) Benefits PRO No Surprises Act dispute resolution services award $1 K for $81 ER visits What You Need To Know - The Centers for Medicare & Medicaid Services posts detailed quarterly results in huge, hard-to-handle files. - Turquoise has posted a tool that shows IDR…...
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