Find a Pharmacy
Vertice Login
Info banner
A significant part of the Healthesystems vision is to create a more integrated experience for our customers

Regulatory Tag: Cost Containment

December 16, 2024
New York Rejects Pharmacy Network Bill

The bill would have allowed injured workers to fill prescriptions at any pharmacy of their choice, including outside of network pharmacies.

READ MORE
December 13, 2024
Ohio Delays Pharmacy Reimbursement Rulemaking to Allow for Stakeholder Input

The Bureau of Workers’ Compensation will take additional time to address stakeholder concerns and make necessary revisions.

READ MORE
December 9, 2024
CMS Publishes 2025 Q1 Updates to NCCI Edits

Changes will impact DME supplier services, facility outpatient hospital services, and practitioner services.

READ MORE
December 3, 2024
California Reports on Inflation’s Impact on State Fee Schedule

The CWCI notes that cumulative percent increases to the Official Medical Fee Schedule have been lower than economy-wide inflation.

READ MORE
November 21, 2024
New York Adopts PBM Regulations, with Exemption for Workers' Comp

Healthesystems' Advocacy & Compliance team successfully engaged the DFS to create an exemption for workers' comp PBMs

READ MORE
November 11, 2024
CMS to Reduce Medicare Physician Fee

The physician fee schedule will be reduced by 2.93%, while other changes are in store for primary care, telehealth, and more.

READ MORE
November 11, 2024
Vermont Seeks Stakeholder Input on Medical Fee Schedule

Written comments from stakeholders who use the fee schedule will be accepted until December 15th.

READ MORE
November 11, 2024
Department of Justice Reaches $21.5 Million Settlement Over Inflated AWP for Compound Ingredients

According to the DOJ, Medisca Inc. purchased resveratrol at $0.37 a gram, sold it for under $2.00 a gram, but reported an AWP of $777 per gram.

READ MORE
November 4, 2024
Mississippi Requests Stakeholder Input for 2025 Fee Schedule

No deadline for feedback has been given, but the Commission will consider feedback for fee schedule changes for 2025.

READ MORE
October 21, 2024
California P&T Meeting Reviews Pharmacy Fee Schedule and Formulary Updates

Public comments for the proposed changes to the fee schedule will be accepted until October 23rd.

READ MORE
October 14, 2024
CWCI: Are Migraine Drugs Becoming a New WC Cost Driver?

Drug payments increased eight-fold since 2018.

READ MORE
October 14, 2024
California P&T Committee to Discuss Pharmacy Fee Schedule

The meeting takes place October 16th to discuss the fee schedule and other matters.

READ MORE
September 30, 2024
Texas Releases 2025 Audit Plan

Audits will focus on timely and accurate reimbursement, bill reporting, and delivery of benefits.

READ MORE
September 16, 2024
Oregon to Hold Rulemaking Advisory Committee Meeting

A November 5th meeting will review fee schedule revisions and certain reimbursement rules.

READ MORE
September 13, 2024
Florida Proposes Prior Auth Requirements for Packs and Kits

Requiring prior authorization would likely reduce utilization, and by extension reduce spend.

READ MORE
lockmap-markermagnifiercrossmenucross-circle