Pharmacy benefit management

BCBSNC wins State Health Plan TPA, PBM contracts

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 awarded the Third-Party Administrator (TPA) and Pharmacy Benefit Manager (PBM) contracts to Blue Cross Blue Shield of North Carolina (BCBSNC) effective January 2028.This will bring BCBSNC back as the TPA after a three-year hiatus. CVS Caremark is the current PBM for the SHP.

Theresa Opeka

News

State Health Plan OKs premium hikes, preferred providers

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.

Theresa Opeka

Opinion

NC’s healthcare crisis: Too much spending, too little care

The two problems that remain are clear: there are too many middlemen, and too little money is reaching the people who actually deliver care to NC residents.

Kerry Willis

News

NC bill would create tax deduction for prescription drug costs

NC House committee advances bill creating tax deduction for up to $5,000 in out-of-pocket prescription drug costs.

Andrew Pomeranz

News

NC reaches $11M deal with EpiPen maker over price increases

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.

Theresa Opeka

News

NC Health Plan delays choice for new administrator after bids fall short

SHP will issue a new RFP in the coming weeks, with the goal to have the plan’s Board of Trustees approve the contract award later this summer.

Theresa Opeka

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News

State Health Plan board votes on benefit restructuring strategies

On Tuesday, the North Carolina State Health Plan Board of Trustees voted unanimously at its meeting to approve the implementation of a three-tier provider network for 2027 that will strengthen the Preferred Provider Program (PPP), which will steer members toward providers at a cost savings for both the member and the State Health Plan (SHP), while delivering a volume of patients to preferred providers.

Theresa Opeka

Opinion

What Trump’s win will mean for North Carolinians’ healthcare

Alarmist rhetoric about what Trump will do to drug prices is largely false.

Mark Cash

Opinion

NC’s Novo Nordisk in Bernie Sanders’ bullseye

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.

Paul Alexander

Opinion

Keep prescriptions affordable and accessible for North Carolinians

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.

Srividya Sankaranarayanan

Opinion

As PBMs help reduce NC drug costs, drug companies push Congress to regulate

Too many North Carolinians suffer from the high cost of prescription drugs. Fifty-four percent of Tar Heels say they struggle to afford the medication they need. Over 30% say they skip taking their prescription drugs to save money. North Carolina’s drug costs problems are only expected to get worse. Pharmacies throughout the state are experiencing substantial supply shortages of...

Christy Lewis

Opinion

Will Congress raise NC’s prescription drug costs?

As a concerned North Carolinian, consumer of healthcare, and an accomplished healthcare executive, I know how important it is for Sens. Ted Budd and Thom Tillis to stand up to the pharmaceutical giants keeping drug prices in North Carolina so high. Even though North Carolina already ranks 37th out of 50 states on healthcare affordability burdens — a problem...

Tim Bevelacqua

BCBSNC wins State Health Plan TPA, PBM contracts

State Health Plan OKs premium hikes, preferred providers

NC’s healthcare crisis: Too much spending, too little care

NC bill would create tax deduction for prescription drug costs

NC reaches $11M deal with EpiPen maker over price increases

NC Health Plan delays choice for new administrator after bids fall short

Help Support Non-profit Journalism & Donate Today

State Health Plan board votes on benefit restructuring strategies

What Trump’s win will mean for North Carolinians’ healthcare

NC’s Novo Nordisk in Bernie Sanders’ bullseye

Keep prescriptions affordable and accessible for North Carolinians

As PBMs help reduce NC drug costs, drug companies push Congress to regulate

Will Congress raise NC’s prescription drug costs?

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