Brooklyn, NY
Joined October 2016
A reader asked whether it is worth auditing a PBM if the guarantees all reconciled. Yes. A guarantee can reconcile on its own definitions and still miss money your plan was owed.
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Bor Bor retweeted
House Oversight Chairman James Comer is investigating whether PBMs retaliated against independent pharmacies that supported reform. The Pharmacists Fight Back Act passed committee 40-2 — and now the question is how far these companies will go to protect their power. Are PBMs targeting independent pharmacies? #PBMReform #IndependentPharmacies #HouseOversight #PBMRetaliation
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Bor Bor retweeted
With big PBMs, someone is always getting ripped off. Great article on why PBMs are afraid of @costplusdrugs healthcarerebelalliance.subs…
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Dear @Humana I will probably never understand how you can pay a pharmacy $537.44 for a box of Toujeo Max 300 unit/ml insulin for a Medicare patient, but yet REFUSE to cover the generic, which costs $165. Oh, and for reference sake, the brand name Toujeo Max wholesale cost is $560.00, so you can take your $537.44 “under-cost payment” and shove it straight up your ass. It seems the rebate incentives of your PBM are severely misaligned with reality. Make it right. Okay thanks, bye. ✌️
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New York loses up to $30 billion a year to fraud and wasted payments. That's up to $2,800 per taxpayer, every year. Most of it is in Medicaid: nursing homes, home health aides, adult day care, medical rides and the insurance companies that manage it all. Some is in MTA contracts. So I checked who those industries fund. @KathyHochul: $2.31 million @TishJames: $92,000 @TomDiNapoli: $88,000 Me: $0 The industries where your tax dollars are most likely to disappear are writing checks to the people who are supposed to watch them. The Comptroller is New York's watchdog. A watchdog fed by the people it's supposed to bark at isn't much of a watchdog. I haven't taken a dollar from these industries. As Comptroller, I'll audit them all. And if you steal from New Yorkers, start getting used to used to bad food and stainless steel toilets because you are going to prison. Data: NYS Board of Elections filings. Anyone can check it.
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New Mark Cuban / 3 Axis Advisors study shows NADAC plus $12 dispensing fee could reduce commercial PBM generic drug charges by 20% or $5.44 per claim. See page 21 @CmrChaNJ static1.squarespace.com/stat…
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#340B reform must be a priority to improve access to healthcare for cancer patients, according to Kim Czubaruk of @CancerCare in a new opinion. Congress should take action to improve 340B transparency and accountability so patients benefit. Read more in @RealClearHealth: realclearhealth.com/articles…
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Private equity keeps moving deeper into healthcare delivery. Doctors keep being told business is beneath them. Meanwhile, the people who understand capital are buying the clinics. Physicians might want to learn the business side before someone else owns the room they practice in. reuters.com/legal/transactio…
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“Express Scripts manages the retail network while owning a pharmacy that competes for those prescriptions. Congress should require a full accounting of those decisions and change the policies that give the contractor’s pharmacy an advantage.” @_APCI apcinet.com/insights-tricare…
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Bor Bor retweeted
Great job Wendell
NEW: We've just released an updated Sunlight Report on UnitedHealth Group. Our research now identifies 2,807 entities across UnitedHealth's sprawling corporate empire, including 376 additional entities since our original report in 2025. Here's what the Center for Health & Democracy (@cforhd) found.
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It’s back! In August 2020, a tropical system named Isaias brought heavy rain and wind to NYC. Now in 2026, a new tropical system with same name has formed. Hurricane names are reused unless they cause major damage and are retired…like Sandy or Katrina.
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Bor Bor retweeted
Ohio released it's report on #340B. Eye opening that Cleveland Clinic reported $272M (as in MILLION) in acquisition costs & $599M in payments for 340B drugs in-house. $22M costs & $70M in payments in 132 contract pharmacies. Can you say 340B profits? odh.ohio.gov/know-our-progra…
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I am honored that Protocols is a No. 1 New York Time Best Seller etc. but people sending me videos of other people reading and highlighting and incorporating the information and protocols in the book is what truly feels gratifying. Video credit: John Joseph, NYC.
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I think I may have just stumbled into one hell of a rabbit hole. What started as a look into one pharmacy owner has now turned into multiple healthcare entities, overlapping corporate identities, government reimbursement, DME, specialty medications, 340B arrangements, and some very interesting changes in the paper trail. I’m still digging, but let’s just say… this one may have fallen right into my lap. 👀
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