21 /PRNewswire/ -- Attorneys representing consumers and third-party payers
today announced a proposed landmark $350 million settlement with healthcare services giant McKesson to settle allegations the company fraudulently inflated the price of more than 400 prescription drugs by manipulating drug-pricing benchmarks.
Over the past few years, third-party payers
, such as large employer-based benefit plans, health maintenance organizations and traditional insurers, have increasingly found a new profit source--recoveries from prescription-drug overcharge litigation.
In a continuing trend, another lawsuit against the tobacco industry has been dismissed by a federal district court, which has ruled that third-party payers
, such as union health and welfare funds, are too remote from any alleged injuries to have standing to sue.
The court stated that third-party payers
could be held liable for "defects in the design or implementation of cost containment mechanisms" that result in the denial of medically necessary services.
A joint development effort of the ACR, the American College of Radiology Imaging Network (ACRIN) and the Academy of Molecular Imaging, the NOPR is a national, Internet-based, audited data repository designed to gather PET data from beneficiaries and providers, and report on that data to third-party payers
including the Centers for Medicare & Medicaid Services.
The court concluded that there was no reason to exempt third-party payers
from the natural consequences of their actions and that an issue of fact existed as to whether the review decision proximately caused the youth's suicide.
This discrepancy in the approval process between drugs and devices has prompted third-party payers
to frequently withhold coverage approval of a device until further evidence of safety and effectiveness is presented.
As we enter the nineties, third-party payers
of health care services are aware of a variety of attempts to control the rising costs of physician, hospital, and other health care services.
increasingly depend on technology assessments to determine coverage eligibility.
Its comprehensive services provide pharmacy benefit management to public and private sector third-party payers
and self-insured employers.
Cancer chemotherapy and AIDS have become focal points in this issue, as new drugs or biologicals can be quite expensive and much of the drug therapy can be categorized as "investigational," a buzzword that signals negative coverage decisions by third-party payers
A significant proportion of the issues addressed by DATA have been raised by third-party payers