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The Knox-Keene Health Care Service Plan Act of 1975 is a set of Californian laws that regulate Healthcare Service Plans. Under these laws, pharmacy benefit managers with contracts to Health care service plans are required by law to be registered with the Department of Managed Health Care to disclose information. [58] SB 966: Pharmacy benefits
AMCP (Academy of Managed Care Pharmacy) is a professional organization representing the interests of pharmacists who practice in managed care settings. [2] [3] [4] It publishes the Journal of Managed Care & Specialty Pharmacy. [5] AMCP is a member organization of the Alliance for a Stronger FDA. [6]
Centene was founded by Elizabeth Brinn as the Managed Health Services in Milwaukee, Wisconsin, in 1984. [3] After the death of Brinn, the non-profit organization was sold to investors, with the proceeds going to the Betty Brinn Foundation, which subsequently became a major shareholder in Centene.
Medco's mail-order business generated $26 billion in 2011 net revenues and was one of the largest pharmacy operations in the United States. In 2011, 113 million of the 757.7 million prescriptions Medco filled were processed through its mail-order pharmacies. In 2011, nearly 10.5 million of the new prescriptions Medco managed were ePrescriptions.
Aetna Inc. is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare.
Magellan Health Inc. (formerly Magellan Health Services Inc.), is an American for-profit managed health care company and subsidiary of Centene that's focused on special populations, complete pharmacy benefits and other specialty areas of healthcare. Magellan supports innovative ways of accessing better health through technology, while remaining ...
It's a bit incongruous, but industrial manufacturing specialist Roper is now the proud owner of Managed Health Care Associates, a New Jersey-based supplier of services for alternate site health ...
Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its medical appropriateness before it is provided, by using evidence-based criteria or guidelines.