For 2017, we have adjusted our product portfolio to include an exclusive provider organization (EPO) in most rating regions. Rating Regions 10 – 14 (Southern San Joaquin Valley counties) will continue to be offered PPO plans. Members on some 2016 PPO plans and all Tiered PPO plans in these areas will be transitioned to EPO plans effective 1/1/17 (unless they choose a different plan). Members will have access to our Pathway network of doctors and hospitals, but their EPO plan will not cover out-of-network benefits.
Some people qualify for big savings on their Medicare prescription drug costs and don’t even realize it! In fact, if you receive Medicare, you may be eligible for the Extra Help, which could save you about $4,000 per year on your monthly premiums, annual deductibles, and prescription co-payments.
Anthem, Inc. today filed suit against Express Scripts, its vendor for pharmacy benefit management services, to recover damages for pharmacy pricing that is higher than competitive benchmark pricing. The lawsuit also seeks to recover damages related to operational issues and for a declaration of Anthem’s right to terminate its contract with Express Scripts.
Health and Human Services Secretary Sylvia M. Burwell announced today that more than $2.2 billion in Ryan White HIV/AIDS Program grants was awarded in fiscal year (FY) 2015 to cities, states and local community-based organizations.