Heads Up: 8 Payment Changes and Challenges in 2025!

We’ve entered a new year and a new era with major proposed changes to healthcare. How sturdy are your three ...

APRIL 10, 2025

Finances May Hinge on Biosimilars, PAs

This month’s column primarily covers two major issues confronting pharmacy: prior authorization and the ...

AUGUST 11, 2024

More on Required Modifiers Under IRA of 2022

Payors, including Medicare, may want to capture particular types of data or use payment information for policy ...

AUGUST 7, 2023

Streamlining PA Rules, Plus Resources for Your e-Library!

PAs remain an entrenched tool for payors to flex their muscles to control spending. Getting up to speed on such PA ...

MARCH 31, 2023

Proposed Payment Rules for FY 2023

Multiple sets of payment rules that operate on a fiscal year (FY) beginning Oct. 1, 2022, have been released this ...

JUNE 28, 2022

6 Steps for Sending Clean Claims to Payors

Pharmacy leaders must be proactive in helping health systems navigate from the financial uncertainty after COVID-19 ...

JUNE 10, 2022

It’s Spring, and Payment Trends Are Blooming

On April 12, urged by hospital groups and other stakeholders, the Department of Health and Human Services renewed ...

MAY 24, 2022