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  2. Prior authorization - Wikipedia

    en.wikipedia.org/wiki/Prior_authorization

    After a request comes in from a qualified provider, the request will go through the prior authorization process. The process to obtain prior authorization varies from insurer to insurer but typically involves the completion and faxing of a prior authorization form; according to a 2018 report, 88% are either partially or entirely manual. [5]

  3. CVS Caremark - Wikipedia

    en.wikipedia.org/wiki/CVS_Caremark

    On May 15, 1996, Caremark International, a provider of manager health services, announced it would be acquired by MedPartners. [5] [6] Caremark International was founded as a unit of Baxter International and was spun off from Baxter in 1992 as a publicly traded company. [5] In 2000, MedPartners changed its name to Caremark Rx. [7]

  4. CVS Health - Wikipedia

    en.wikipedia.org/wiki/CVS_Health

    In the late 1980s and early 1990s Caremark RX was involved in a number of health fraud and Medicare fraud scandals. [ 53 ] [ 54 ] The combined price to settle this dispute with the U.S. Government cost the company over $250 million.

  5. Medicare Access and CHIP Reauthorization Act of 2015

    en.wikipedia.org/wiki/Medicare_Access_and_CHIP...

    Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), (H.R. 2, Pub. L. 114–10 (text)) commonly called the Permanent Doc Fix, is a United States statute. Revising the Balanced Budget Act of 1997 , the Bipartisan Act was the largest scale change to the American health care system following the Affordable Care Act in 2010.

  6. Express Scripts - Wikipedia

    en.wikipedia.org/wiki/Express_Scripts

    Express Scripts began in 1986 in St. Louis County, Missouri as a result of a joint venture between a retail chain of more than 79 pharmacies (Medicare Glaser Inc.) and Sanus Corp. Health Systems. Sanus traces its history to Bradford Systems and Administrative Services which was founded in Boston in 1968. Bradford had a contract for computer ...

  7. AdvancePCS - Wikipedia

    en.wikipedia.org/wiki/AdvancePCS

    AdvancePCS Inc. (Pharmaceutical Card System) was a large prescription benefit plan administrator from the United States, also known as a PBM (Pharmacy Benefit Manager). The company was partially purchased by McKesson in 1969 and fully in 1972.

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