Prescription Drugs - Medicine & Money
The truth about prescription drug costs.
Just a cost of doing business: PBMs pay multimillions in fraud judgments and settlements to avoid even more costly judgments. This is just the total for the biggest PBMs!
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Government to insurance agents: Quit preying on the elderly
Government to insurance agents: It’s time to stop preying on the elderl
Imagine your grandmother, ambushed in her grocery store parking lot by a salesperson pressuring her to change her Medicare coverage, a system convoluted enough to confuse just about anyone.
It sounds unbelievable, right? Unfortunately, it’s exactly what insurance companies are up to.
Insurance companies have spotted an easy target - seniors living on fixed incomes struggling to make ends meet while trying to make sense of Medicare – and are taking advantage of the situation, aggressively pushing private plans called Medicare Advantage on seniors.
When the companies switch seniors to different insurance plans without first fully explaining the change, it has caused some to lose supplemental coverage and physician access.
States currently don’t have the power to regulate the companies that issue these plans. Some argue that states should have the authority to do so, but insurance companies say they would rather see regulation at the federal level than have to deal with 50 states, each with a different set of rules.
Meanwhile, state officials say the only way insurance agents will come clean, and the only way they can look out for seniors, is if they have the muscle to make it happen.
States belonging to the National Association of Insurance Commissioners have received many complaints they can’t do anything about, leaving consumers to fend for themselves. Like figuring out Medicare, navigating the labyrinth of Centers for Medicare and Medicaid Services and state regulators is a daunting task.
The NAIC wants to set standards for marketing private plans that would be enforced by the states that adopt them.
In what could be interpreted as steps toward ending this swindling or politicians caving in to lobbyist pressure, the federal government proposed to ban insurance agents’ aggressive marketing of private Medicare comprehensive and prescription drug coverage last month.
The federal proposal does not address state regulation.
Senate Finance Committee Chairman Max Baucus of Montana was quoted by The Wall Street Journal as saying, "America's seniors have been pressured, prodded, preyed on and ripped off by shady marketing too often. I intend to get these bans into the law to ensure aggressive marketing tactics are quashed once and for all.”
Medicine and money! For every prescription you buy, middlemen grab an average $5 to $7 per prescription. Who are the middlemen? They are pharmacy benefit managers--bean counters who contribute nothing to your health care but suck money from patients, private business and governments.If you like how HMOs controlled your access to physicians, you'll love how PBMs control your access to medicine.
This site provides a place for you to sound off on the issue. You also will learn what you as a voter can do about it.