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The state's Network Adequacy and Transparency Act requires insurers to keep an up-to-date provider directory, listing healthcare professionals that are in-network for its customers.
Prescription drug monitoring programs, or PDMPs, are an example of one initiative proposed to alleviate effects of the opioid crisis. [1] The programs are designed to restrict prescription drug abuse by limiting a patient's ability to obtain similar prescriptions from multiple providers (i.e. “doctor shopping”) and reducing diversion of controlled substances.
Five factors that can be used to assess the advancement level of a particular IDN include provider alignment, continuum of care, regional presence, clinical integration, and reimbursement. [5] Between 2013 and 2017, healthcare providers created 11 new integrated delivery systems from joint ventures with insurance companies. [6]
Names; All geographical identifiers smaller than a state, except for the initial three digits of a zip code if, according to the current publicly available data from the U.S. Bureau of the Census: the geographic unit formed by combining all zip codes with the same three initial digits contains more than 20,000 people; the initial three digits of a zip code for all such geographic units ...
A drug policy is the policy regarding the control and regulation of psychoactive substances (commonly referred to as drugs), particularly those that are addictive or cause physical and mental dependence. While drug policies are generally implemented by governments, entities at all levels (from international organisations, national or local ...
When used appropriately, formularies can help manage drug costs imposed on the insurance policy. [7] However, for drugs that are not on formulary, patients must pay a larger percentage of the cost of the drug, sometimes 100%. Formularies vary between drug plans and differ in the breadth of drugs covered and costs of co-pay and premiums.
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The Food and Drug Administration in the United States, mainly under the Federal Food, Drug, and Cosmetic, oversees the advertising of prescription drugs to ensure accurate and truthful communication. In 2015, the American Medical Association called for the banning of direct-to-consumer advertising because it is linked with increased drug prices ...