In addition to voting on preferred provider hospital systems, benefit changes, and premiums for 2027 at its Friday board meeting, the North Carolina State Health Plan Board of Trustees also voted to bring BCBSNC back after a three-year hiatus.
On Friday, the North Carolina State Plan Board of Trustees (SHP) voted on what are being called monumental changes to the Plan over the next few years, including preferred provider hospital systems, benefit changes, and premiums for 2027, and the announcement of a Third Party Administrator (TPA) and Pharmacy Benefit Manager (PBM) for 2028, in an effort to make improvements and reduce overall costs for the nearly 750,000 members covered by the Plan.
At a press conference at the North Carolina Department of Justice on Thursday, North Carolina Attorney General Jeff Jackson announced that the state has reached an $11 million settlement with Mylan, the maker and distributor of the EpiPen, for a number of anti-competitive practices that allowed it to mark up the price by 6 times in the state in under a decade.
Lawyers representing the North Carolina State Health Plan are asking the 4th US Circuit Court of Appeals to throw out an injunction against the plan in a dispute over coverage for medical treatments typically sought by transgender patients.
The US Supreme Court has vacated a lower court ruling against the North Carolina State Health Plan in a case dealing with coverage of medical treatments typically sought by transgender patients. The high court issued an order Monday calling for the 4th US Circuit Court of Appeals to give the case “further consideration in light of United States v. Skrmetti.”
The US Supreme Court will review Thursday a case involving North Carolina State Health Plan coverage of medical treatments typically pursued by transgender patients. The case Folwell v. Kadel is scheduled for a closed-door review.
State Treasurer Brad Briner’s office believes Wednesday’s US Supreme Court decision in a Tennessee case will help resolve North Carolina’s legal battle over State Health Plan coverage of medical treatments for transgender patients.
Stalled contract negotiations between CVS Caremark and the State Treasurer could result in a possible court battle and insolvency for the State Health Plan.
Folwell is right that these weight-loss drugs strain budgets at the current price. But the sky-high prices are due to PBMs not drug companies.
I am worried about possible legislation here in NC that would compromise patient safety and impede PBMs’ ability to manage costs for patients like the ones I serve.
North Carolinians who are on the State Health Plan (SHP) for their medical insurance will not see an increase in their premiums for the 2024 benefit year. State Treasurer Dale Folwell
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