Policy & Sector Insights

By Alex Spanko Skilled Nursing News Families of nursing home residents have spent the past year appealing to policymakers that COVID-19 lockdowns were having a significantly negative effect on their loved ones’ health — and a new study put some sobering numbers on the physical impact of loneliness. The proportion of residents experiencing unexpected weight […]

McKnight’s Long-Term Care News  By Danielle Brown – September 16, 2020 Long-term care pharmacies could soon be facing “significant ramifications in the long run” following an executive order signed by President Trump on Sunday. That directive states that the Medicare program should not pay more for Part D prescription drugs than the lowest price. More […]

McKnight’s Long-Term Care News | May 4, 2020 By James M. Berklan As long-term care providers continue to struggle with the deadly implications of COVID-19, hesitation could be their biggest threat, says one of the profession’s top leaders. With clinical, regulatory and financial conditions shifting almost day-to-day, providers must be confident enough to devise a well-educated […]

As you may know, many Part D Plans/PBMs and other government payers (Medicare, Medicaid and TRICARE) recently began seeking audit recoupments from pharmacies that do not dispense insulin pens in multi-dose packaging as provided by manufacturers.  SCPC understands that this payment policy change is causing confusion in the marketplace and could be disruptive to effective […]

Washington, DC – In previously noting that capping Medicare beneficiaries’ out-of-pocket costs as low as possible is a primary long-term care (LTC) pharmacy advocacy priority as Congress debates drug pricing reform legislation, the Senior Care Pharmacy Coalition (SCPC) also recommended two pharmacy benefit manager (PBM) transparency provisions be included in the pending Prescription Drug Pricing […]

Morning Consult | February 28, 2020 By Alan G. Rosenbloom  When it comes to the “alphabet soup” of three- and four-letter federal agencies, one’s eyes can glaze over in confusion about what they do, why they do it and how average citizens benefit from their federally funded oversight. In the realm of health policy and our […]

Washington, DC – With media attention increasingly focused upon the “inflationary rebate” facet of the Senate Finance Committee’s Prescription Drug Pricing Reduction Act of 2019 (S. 2543), the Senior Care Pharmacy Coalition (SCPC) today said capping Medicare beneficiaries’ out-of-pocket costs as low as possible remains a top long-term care (LTC) pharmacy advocacy priority. “Capping Medicare […]

Fox 25 Oklahoma – January 24, 2020 By Destiny Washington OKLAHOMA CITY (KOKH) — Oklahoma could soon join the growing number of states backing away from using Pharmacy Benefit Managers (PBM’s) to administer prescription-drug programs. A PBM is a third-party administrator of prescription drug programs for state and federal government employee plans, self-insured employer plans, commercial […]

Morning Consult– January 23, 2020  By B. Douglas Hoey Very few people know what pharmacy benefit managers do. The three biggest rival the largest corporations in the world in terms of market capitalization, revenue and profits. The CVS Health pharmacy service segment, for example, reported $134 billion in revenue last year. The PBMs exert enormous influence on […]