Dossier
Optum
Coverage of Optum in the Nexus archive.
Pennsylvaniaplace1pharmaciestopic1pharmacy benefit managerstopic1Medicaidtopic1Philadelphia Association of Retail Druggistsorganization1Rob Frankilperson1CVS Caremarkorganization1Express Scriptsorganization1Pharmaceutical Care Management Associationorganization1John Conollyperson1Minnesota Department of Human Servicesorganization1Centers for Medicare & Medicaid Servicesorganization1Trump administrationorganization1Minnesota Medicaidorganization1Medicaid fraudtopic1
- Tucked in the state budget, a win for pharmacies looking for PBM regulation
Pennsylvania's state budget includes a provision requiring pharmacy benefit managers (PBMs) to allow pharmacies previously removed from their networks to reapply after 12 months, addressing concerns about arbitrary contract terminations. The measure, supported by pharmacists, does not resolve broader issues like low reimbursement rates but aids struggling pharmacies.
- Minnesota Medicaid congressional fraud hearing: $1B in losses under review
Minnesota’s Medicaid director is testifying before Congress about fraud in the state’s Medicaid program, which faces a $1 billion loss estimate from January 2022 to October 2025. Federal officials deferred $350 million in Medicaid funding after an audit found unusually high spending and rapid growth in 14 high-risk programs.