The Wild West Sits One Out: AB 52 is Delayed Until 2012 as California Backs Down to Health Insurance Company Interests

2011 ◽  
Author(s):  
Craig B. Garner
Keyword(s):  
Health Insurance ◽  
Health Insurance Company ◽  
Insurance Company ◽  
Wild West

PMU20 Burden of Disease in Young Population of a Colombian Health Insurance Company

2021 ◽  
Vol 24 ◽  
pp. S148
Author(s):  
Sotomayor M Carrasquilla ◽  
N. Alvis-Zakzuk ◽  
Mejía F Salcedo ◽  
L. Moyano ◽  
N.R. Alvis-Zakzuk ◽  
...  
Keyword(s):  
Health Insurance ◽  
Burden Of Disease ◽  
Health Insurance Company ◽  
Insurance Company ◽  
Young Population

Medications requiring prior authorization across health insurance plans

2020 ◽  
Vol 77 (8) ◽  
pp. 644-648
Author(s):  
Laney K Jones ◽  
Ilene G Ladd ◽  
Michael R Gionfriddo ◽  
Christina Gregor ◽  
Michael A Evans ◽  
...  
Keyword(s):  
Health Insurance ◽  
External Factors ◽  
Insurance Companies ◽  
Health Insurance Company ◽  
Prior Authorization ◽  
Insurance Company ◽  
Insurance Plan ◽  
Narcotic Analgesics ◽  
Health Insurance Companies ◽  
Effective Use

Abstract Objective To determine the amount of variation in numbers and types of medications requiring prior authorization (PA) by insurance plan and type. Methods Most health insurance companies require PA for medications to ensure safe and effective use and contain costs. We generated 4 lists of medications that required PA during 2017 for commercial, marketplace, Medicaid, and Medicare plans. We aggregated medications according to the generic medication name equivalent using codes and medication names. We compared these medications to assess how many of the medications required PA by 1, 2, 3, or all 4 of the insurance plans. We counted all prescription orders written for a patient age 18 years or older with health plan insurance during 2017 for any of the medications that appeared on the health plan’s PA lists by querying the electronic health record. Results PA was required for 600 unique medications in 2017 across the 4 plans. Of 691,457 prescription orders written for 114,159 members, 31,631 (5%) were written for 1 of the 600 medications that required PA by at least 1 insurance plan. There were 12,540 medication orders (written for 6,642 members) that potentially required PA. The marketplace plan required PA for the greatest number of medications (440), followed by the Medicare (272), commercial (271), and Medicaid (72) plans. The most commonly prescribed classes of medications for which PA was required by at least 1 plan were antihyperlipidemics (22% of orders potentially requiring PA), narcotic analgesics (13%), hypnotics (12%), antidiabetic medications (9%), and antidepressants (9%). For only 25% of medications (151 of 600) was PA required by at least 3 plans, and for only 5% (32 of 600) was PA required by all 4 insurance types. Conclusion Medications requiring PA can differ within a single health insurance company, but this variation may be unavoidable due to external factors.

A health insurance company-initiated practice support intervention for optimizing acid-suppressing drug prescriptions in primary care

2011 ◽  
Vol 23 (8) ◽  
pp. 664-670 ◽  
Author(s):  
Hugo M. Smeets ◽  
Arno W. Hoes ◽  
Nicolaas P.A. Zuithoff ◽  
Paul C.M. van Dijk ◽  
Arnold P.M. van der Lee ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Insurance ◽  
Drug Prescriptions ◽  
Health Insurance Company ◽  
Insurance Company ◽  
Support Intervention
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