News

Webinar on Demand: Meeting the Mandate—The TPA Path to RxDC Success

The RxDC Reporting Deadline is Approaching—Are you Prepared? At AlignRx, we provide our valued TPA partners and their employer groups with year-round pharmacy consulting and expertise. The RxDC mandate is no exception. We covered: PBM timelines—and how they impact yours Understanding PBM charges for data submission communicating them with your clients Rebates, rebates, rebates! Ensuring …

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RxDC TPA Guide – What TPAs Need to Know

The RxDC Reporting Deadline Is Approaching—Are You Prepared? The Consolidated Appropriations Act has a new Rx mandate for your employer groups and the deadline is approaching—are you prepared? The new mandate requires employer-based health plans to submit information about prescription drug and healthcare spending to the Departments of Health & Human Services, Labor, and the …

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How specialty drug ‘solution stacking’ can rein in pharmacy benefit costs

Brokers and employer groups alike know that 5% to 10% percent of insured workers and their dependents drive 50% to 60% of the cost of pharmacy claims. A few members with prescriptions for a specialty drug with a five-figure price tag can easily represent the majority of an entire group’s pharmacy spend. These drugs are …

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Prediabetes and Type 2 Diabetes Screening

What is happening:  In August 2021 the United States Preventive Services Task Force (USPSTF) recommended that adults, aged 35 to 70 years who are overweight or obese, be screened for prediabetes or type 2 diabetes. In addition to these screenings, USPSTF recommended that clinicians should offer patients with prediabetes effective preventive interventions. Preventive interventions include …

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What Employers, TPAs and Brokers Need to Know About COVID 10 Home Testing

January 10, 2022, the U.S. Department of Labor (DOL) issued guidance related to insurance coverage for COVID OTC testing, provided at no cost to covered individuals that was effective as of January 15, 2022. COVID 10 Home Testing Highlights Beginning January 15, 2022, most individuals with health insurance can purchase at home over-the-counter COVID-19 diagnostic …

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How Digital Therapeutics Are Paid For Has Huge Implications

Digital Therapeutics (DTx) have been increasingly popular since smartphones and wearable tech have become ubiquitous. The pandemic has set them on a trajectory for massive growth and mainstream adoption. Currently, there is inconsistency in how DTx are handled by payers and health plans. We are at a critical juncture to set precedents that make sense …

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