FORT WORTH, TX – In its work to reduce the cost of employee health care claims, the City of Fort Worth has excluded 24 suspect pharmacies from billing its plan, preventing $1.7 million in fraudulent payments to date, without member disruption. For several years, Fort Worth officials have worked with
How the City of Fort Worth Saved Millions In the United States, prescription drug spending in 2020 reached $358.7 billion; $3.5 billion is estimated to be fraud, waste, and abuse. The City of Fort Worth, Texas — the 12th largest city in the U.S. and the 5th largest in the
The No Surprises Act took effect this year and employers could see some positive impacts to their self-funded health plans in the form of reduced out-of-network costs and simplified regulatory requirements. The new law was approved by Congress in 2020 and went into effect Jan. 1, 2022.1 The basis of
Employers with self-funded employee health plans have long felt protected from state laws that attempted to regulate ERISA plans, however a U.S. Supreme Court case decided last year may begin to change that, according to benefits attorney Felicia Finston. The 2021 Supreme Court decision in Rutledge v. Pharmaceutical Care Management
Employers aiming to reduce health care plan costs could go back to the dictionary when it comes to their summary plan descriptions. From reviews of self-funded employer health care claims, analysts have found broad, sweeping definitions of “physicians” which resulted in services billed at the higher physician rate even though
