The Board of Examiners for Nursing on Wednesday revoked the licenses of three nurses and disciplined six others. The board revoked the registered nurse (RN) license of Charlene Zikaras of Milford for continuing to practice as a nurse after being told to stop by the state. Zikaras, who worked at the Stamford Ambulatory Surgical Center, had her license placed on probation for four years in December 2018 for alcohol abuse and was required to submit urine screens. On April 22, Zikaras’ urine tested positive for alcohol and on May 3 she was told to refrain from working as a nurse. Zikaras went to work on May 8, the Department of Public Health (DPH) reported.
Pharmacy benefit managers – the middlemen who negotiate drug purchases for insurers and large buyers – are coming under growing scrutiny and criticism both in Connecticut and nationwide for their role in the sharp rise of prescription drugs. The third-party companies, called PBMs for short, originally processed claims for pharmacies, but now are hired by Medicare, Medicaid and commercial health plans to manage pharmaceutical benefits. Their reach is broad: they choose what drugs are covered by insurance; negotiate purchasing deals with drug makers; determine co-pays for consumers; decide which pharmacies will be included in prescription plans; and decide how much pharmacies will be reimbursed for the drugs they sell. The growing legions of PBM critics, who include state Comptroller Kevin Lembo, pharmacists and their trade and service organizations, say that the industry is helping drive the unrelenting rise in prescription drug prices and insurance premiums.
PBMs, Lembo’s office and state pharmacists say, use a variety of tactics to capture cash from consumers, payers and pharmacies. One is spread pricing, where they pay the pharmacy less for a prescription than a payer gives them, sometimes even forcing the pharmacist to take a loss.
Although Gov. Ned Lamont said nothing about health care policy in his inaugural speech to the General Assembly, it’s likely to be a major theme of at least his early months in office. Why? Depending on how it’s calculated, health care makes up 25 to 30 percent of the state budget, according to the Office of the State Comptroller. Lamont will have to balance the need to save money with the desire of many inside and outside the General Assembly to expand and improve health care coverage and lower costs for consumers. “There’s almost two levels,” said Patricia Baker, president and CEO of the Connecticut Health Foundation, which focuses on assuring health equity and access to affordable care for all.