Remember back in 2009, when some on Wall Street swore the sky was falling as Caremark came off a tricky selling season? Oh, how times have changed.


There is no doubt about it. Pharmacy audits can be time consuming and laborious for all parties involved. And as both government and commercial money gets tighter and tighter, all of health care is searching for the most effective means to manage the financial challenges associated with doing business. In addition to the clinical aspects, audits are used to identify genuinely fraudulent or erroneously paid healthcare claims. Nevertheless, a survey released in September 2012 by the National Community Pharmacists Association found that nearly 87% of those surveyed stated that reimbursement and auditing practices are “significantly” or “very significantly” affecting their ability to provide patient care and remain in business.

Will Congress rip away the ability of independent and small chain pharmacies to sell diabetic supplies and durable medical equipment to Medicare patients?

As states grapple with tight budgets, rising Medicaid costs and the anticipated expansion of Medicaid following the Supreme Court’s decision to uphold the Patient Protection and Affordable Care Act, policy-makers should consider how community pharmacists can help reduce expenses.

Beginning this month, South Carolina is allowing retail-based health clinics to enroll as providers in Medicaid, a move that will enable Medicaid patients to use clinics for wellness visits, preventive services and to treat acute ailments, according to a local news report.

A new study from Harvard School of Public Health found that expanding Medicaid to low-income adults led to improved health and reduced mortality. It is the first published study to look specifically at the effect of recent state Medicaid expansions on mortality among low-income adults.

While the Supreme Court on Thursday morning left the Patient Protection and Affordable Care Act mostly intact, the court did rule that Congress cannot withhold federal Medicaid spending from a state that does not expand its eligibility requirements under the act.

Ohio's Medicaid program has decided not to establish a competitive bidding and mandatory mail-order program for diabetes testing supplies.

How do you squeeze water from a stone? That seems to be the goal of the U.S. Centers for Medicare and Medicaid Services in its long quest to cut prescription reimbursements for Medicaid patients by setting new, tighter payment caps for the community pharmacies that dispense those medicines.

The Supreme Court has sent a lawsuit challenging cuts to California's Medicaid program back to a lower court.

The National Community Pharmacists Association is calling for the Centers for Medicare and Medicaid Services to allow senior patients to enroll in a new Medicare Part D prescription drug plan via a special enrollment period, particularly if patients believe that "material misrepresentations" led them to sign up for a "preferred network" plan with inadequate pharmacy access.

A bill proposed in Congress would give states incentives for using generic drugs through the Medicaid program.