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Jan
16

Third Party Solutions – the latest news

TPS, a subsidiary of Fiserv, has had a rather tumultuous recent history. For sale for a reported $200+ million, then taken off the block when no buyers appeared. Left behind when Fiserv sold the rest of its health business to United Healthcare earlier this year. Meanwhile, TPS was buying its sole competitor, WorkingRx for a reported $25-50 million (highly contingent on AR collections).
Earlier this week I noted that WorkingRx has filed over a hundred individual cases in Utah naming specific employers liable for ‘shortpays’ (payments of less than WRx thinks they’re owed). In my opinion, WRx overreached; the filings named the pharmacies that filled the scripts – and when employers find out which pharmacies are behind this mess, they will be none too happy.
WRx’s General Counsel, Rex Huang, left the firm just before the end of the year.
With Huang’s departure, the rapid disappearance of senior staff at WRx is now close to complete.
The third party biller market is now a monopoly, and some pharmacy chains indicate the pricing proposals from TPS are starting to reflect that.


Joe Paduda is the principal of Health Strategy Associates

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A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.

 

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