Wendell, you should also research and write an article on the Regulatory corruption with the industry and Regulatory collusion. Regulators getting paid by Pharmacy companies. How would someone in Government earn and get paid a royalty? That corruption would be a good article. And if its not corruption, what is it and how does it make sense?
Agreed about the need for reform. Are you aware of any pending legislation or ongoing efforts to draft legislation to institute reform? I would expect fierce resistance from the companies you mention, and others.
House Bill 9096 Pharmacists Fight Back Act. We have 39 cosponsors to date and are shooting for 50 by Thanksgiving. Please ask your Congressman to support this bill. And yes the PBMs are fiercely resisting- running deceptive ads all over social media, Politico, Axios, etc. One of the companies that uses AI to deny claims is referring to themselves as an 'Advocate' haha not
I am not familiar with current PBM regulatory legislation, but I suspect that "bipartisan" will mean little in a lame duck session with upcoming MAGA power which seeks to reduce industry regulation and maximize the revenues of profiteering. I think our challenge starts next year. We have to create new language and easily graspable numbers that can reach MAGA voters and help them understand how much they are PERSONALLY harmed, physically and financially, by the under-the-table price-gouging practices of PBMs. "Reforming" PBMs is a quixotic goal. Ultimately, they have to be removed from the health care world, like leaches were a century and a quarter ago
Last week, my Medicare Part D insurer tiered up a medication I've been taking for years for pain relief so high that my doctor will have to submit copious paperwork to get me approved to continue taking it. The drug is very old, cheap, is generic, has no substitute, and probably has no profit-making potential. I regret having to request this from my pain doctor. Her time has been eaten up by prior authorization documentation for nerve block procedures with regular Medicare.
The drug is NOT an opiate, is effective, and does not cause me any side effects. I have at least 20 allergies/negative side effects in my medical history. I have no wish to try a new, expensive drug. I suspect the PBM does not wish to dispense the drug.
My choices are to encumber my doctor further with a request for the additional paperwork or discontinue the medication and continue with added chronic pain. SMH
And why should it matter who pays our deductible. It’s disgusting that just because I have a patient assistance card it can’t be used towards my deductible. PBMs are criminal.
Wendell, you should also research and write an article on the Regulatory corruption with the industry and Regulatory collusion. Regulators getting paid by Pharmacy companies. How would someone in Government earn and get paid a royalty? That corruption would be a good article. And if its not corruption, what is it and how does it make sense?
The lobbyists are the reason we can't have necessary things.
Agreed about the need for reform. Are you aware of any pending legislation or ongoing efforts to draft legislation to institute reform? I would expect fierce resistance from the companies you mention, and others.
House Bill 9096 Pharmacists Fight Back Act. We have 39 cosponsors to date and are shooting for 50 by Thanksgiving. Please ask your Congressman to support this bill. And yes the PBMs are fiercely resisting- running deceptive ads all over social media, Politico, Axios, etc. One of the companies that uses AI to deny claims is referring to themselves as an 'Advocate' haha not
oops good news! 43 cosponsors!
How do I find out who has already sponsored this bill?
I am not familiar with current PBM regulatory legislation, but I suspect that "bipartisan" will mean little in a lame duck session with upcoming MAGA power which seeks to reduce industry regulation and maximize the revenues of profiteering. I think our challenge starts next year. We have to create new language and easily graspable numbers that can reach MAGA voters and help them understand how much they are PERSONALLY harmed, physically and financially, by the under-the-table price-gouging practices of PBMs. "Reforming" PBMs is a quixotic goal. Ultimately, they have to be removed from the health care world, like leaches were a century and a quarter ago
Last week, my Medicare Part D insurer tiered up a medication I've been taking for years for pain relief so high that my doctor will have to submit copious paperwork to get me approved to continue taking it. The drug is very old, cheap, is generic, has no substitute, and probably has no profit-making potential. I regret having to request this from my pain doctor. Her time has been eaten up by prior authorization documentation for nerve block procedures with regular Medicare.
The drug is NOT an opiate, is effective, and does not cause me any side effects. I have at least 20 allergies/negative side effects in my medical history. I have no wish to try a new, expensive drug. I suspect the PBM does not wish to dispense the drug.
My choices are to encumber my doctor further with a request for the additional paperwork or discontinue the medication and continue with added chronic pain. SMH
And why should it matter who pays our deductible. It’s disgusting that just because I have a patient assistance card it can’t be used towards my deductible. PBMs are criminal.
Is there a current bill
In Congress? They’re such dufuses I don’t think they’ll pass shit before 12/31/24.
They didn’t stop the Medicare cuts, and they haven’t passed the site neutrality bill.
I hope I’m wrong and they can pass PBM reform and prove me wrong