Inside the Industry

Senate Bill 526 outlines a process that patients and physicians could use to get health insurers to cover medications. Insurers often balk at the price of these drugs and try to force the patient to first try a cheaper alternative.

Patient advocates and pharmaceutical companies are backing legislation that would give physicians an easier time prescribing medication and bypassing “step-therapy” protocols, which health insurers use to limit the dispensation and purchase of high-cost drugs.

Feb 22 2017
The Oregon Psychological Association is trying to resolve the problem amicably

Psychologists find themselves at odds with insurance companies over reimbursement, and, for the first time, the Oregon Psychological Association is taking a pro-active stance.

“It’s getting more and more difficult to get reimbursed when people have serious mental health issues,” Shana Koslofsky, PhD, president of the Oregon Psychological Association, told The Lund Report. 

Feb 22 2017
Meanwhile employees at PeaceHealth Labs are receiving pink slips as Quest Diagnostics proceeds to take over.

Laboratory Corporation of America has announced plans to purchase Pathology Associates Medical Laboratories, a story that was first reported in The Lund Report. PAML broke the news to its employees this afternoon.

Feb 22 2017
House Bill 2388 will strengthen the existing regulation of pharmacy benefit managers by giving the Department of Consumer & Business Services the ability to investigate complaints and cancel a company’s registration if the PBM commits fraud or fails to pay civil penalties.

Pharmacists appear poised to add significant teeth to the state law regulating pharmacy benefit managers, persuading the Legislature to make the first changes to the law since it was enacted in 2013.

Feb 17 2017
The announcement was revealed on his Linked In page.

A leading health insurance executive is stepping down. Andrew McCulloch, president of Kaiser Foundation Hospitals and Health Plan of the Northwest, plans to retire in July, informing his employees last Friday and, at the same time, posting an announcement on Linked In.

Feb 15 2017
At the same time, Providence is still planning to sell its laboratory services to the Laboratory Corporation of America.

Quest Diagnostics announced today that it will purchase PeaceHealth’s outreach laboratory, a story that was first reported in The Lund Report last week.

Feb 15 2017
It’s becoming too expensive to keep oncologists as part of an independent multi-specialty medical clinic.

Independent medical clinics face a more difficult time keeping oncologists on board because of declining drug revenue and the higher salaries earned by oncologists.

Feb 15 2017

The confirmation of Tom Price, the orthopedic surgeon-turned-Georgia congressman, as secretary of Health and Human Services represents the latest victory in the ascendancy of a little-known but powerful group of conservative physicians in Congress he belongs to — the GOP Doctors Caucus.

Feb 15 2017
Physicians and insurers agree that a consumer shouldn’t be punished financially for mistakenly going outside a health plan network, but the two sides are at loggerheads over setting a fair payment for health services provided out of network.

Insurers, physicians, and consumer advocates all agree: surprise bills are a big problem.

Consumers are making numerous complaints about attempting to utilize their health plans’ networks, only to find some providers and services at Oregon hospitals are not actually in their network.

Feb 15 2017

Premiums for Obamacare plans sold by New Mexico Health Connections could rise as little as 7 percent next year, says Martin Hickey, the insurance company’s CEO. Or they might soar as much as 40 percent, he said.

Feb 10 2017