Pharmacy benefit managers (PBMs) took $123.5 million in spread pricing from Kentucky Medicaid plans, according to a state report; Richard Sackler, MD, the former president of OxyContin maker Purdue Pharma, repeatedly gave testimony in an opioid lawsuit that conflicts with a federal report, according to court papers; rural state lawmakers in Kansas are pushing a plan to allow the Farm Bureau to offer health insurance coverage, but Democrats and others are critical of the idea.
Pharmacy benefit managers (PBMs) took $123.5 million in spread pricing from Kentucky Medicaid plans, according to a state report. Bloomberg reported that 4 Kentucky insurers in Medicaid paid $957.7 million to 4 PBMs that use the arrangements last year. Of that, the PBMs kept 13% through spread pricing, and the size of the spreads rose by more than a third from 2017, the state found. Reports from other states have found similar patterns.Richard Sackler, MD, the former president of OxyContin maker Purdue Pharma, repeatedly gave testimony in an opioid lawsuit that conflicts with a federal report, according to court papers obtained by ProPublica and STAT News. The court papers that indicate Sackler endorsed marketing efforts to conceal the opioid’s strength from physicians as soon as a year after the drug's 1996 launch. During a previous pretrial deposition he said he first learned from a Maine newspaper article in 2000 that the painkiller was being abused.Rural state lawmakers in Kansas are pushing a plan to allow the Farm Bureau to offer health insurance coverage to members without having to comply with Affordable Care Act mandates in hopes that the agriculture group's plan will have a lower price, the Associated Press reported. But the proposal is drawing strong criticism from Democrats and health groups because a Farm Bureau plan would not be required to cover people with pre-existing medical conditions.
AI in Health Care: Balancing Governance, Innovation, and Trust
September 2nd 2025In this conversation with Reuben Daniel, associate vice president of artificial intelligence at UPMC Health Plan, we dive into how UPMC Health Plan builds trust with providers and members, discuss challenges of scaling AI effectively, and hear about concrete examples of AI's positive impact.
Listen
Team Coordination, Data Sharing Help Prioritize Value in Cardio-Renal-Metabolic Care
September 12th 2025Cardiologists, nephrologists, and payers met in Scottsdale, Arizona, on August 26, 2025, to share insights on how team members can work together, empowered by data, to achieve value-based management of cardio-renal-metabolic syndrome.
Read More