Andrew

I read PBM contracts so you don’t have to cry alone | Recovering statehouse staffer | Flow state enthusiast

[Andrew @ajdezelan]

One company (CVS) owns the insurer (Aetna), owns the PBM (CVS Caremark), owns the specialty pharmacy (CVS Specialty), and increasingly owns the clinics (Minute Clinic, Oak Street) too.

The entity deciding what gets covered is the same entity deciding what it costs to fill it, which is the same entity billing you for the visit.

That’s not a conflict of interest. That’s a closed loop with a logo.

[Antonio Ciaccia @A_Ciaccia]

“CVS also has a structural edge” is such a formal and polite way to say “they can pay themselves more than their competitors.”

https://t.co/07J2bZxIMO

[Andrew @ajdezelan]

Many people are saying that Governor Ballard will restore Energizing Indiana in his first term

[Andrew @ajdezelan]

Do you all want to see where the bodies are buried or do you want to see why the Duo is a shortsighted purchase over an iPad mini + Cellular + Mchip

[Andrew @ajdezelan]

Here lies the Autonomous Vehicle Bill (HB 1341). Killed by a clock.
This one is for the people who were in the building on March 14, 2018. If you know, you know.

HB 1341 had everything a bill is supposed to need. It was the Governor's priority. The House passed it 94–0. The Senate passed it. It went to conference and came out with a deal.

Then it sat on the House floor and waited. The clock hit midnight. Five bills were still sitting there when the session expired, and the self-driving car bill was one of them.

Some in the building blamed the 11th-hour holdup on the bill's own author. The House transportation chair ran out the session's clock on his own priority.

It gets better.

Gov. Holcomb called a special session in May to clean up the mess. He left autonomous vehicles off the list.

So Indiana's self-driving future didn't die from opposition. It didn't die from a bad vote. It never got a vote. Unanimous support, both chambers, a conference deal, and no time on the clock.

The technology was autonomous. The legislative calendar was not.

Floor time is the most precious resource in that building, and it doesn't care how good your bill is.

[Andrew @ajdezelan]

@PaulHFlowersJr It gets better

[Andrew @ajdezelan]

One company (CVS) owns the insurer (Aetna), owns the PBM (CVS Caremark), owns the specialty pharmacy (CVS Specialty), and increasingly owns the clinics (Minute Clinic, Oak Street) too.

The entity deciding what gets covered is the same entity deciding what it costs to fill it, which is the same entity billing you for the visit.

That’s not a conflict of interest. That’s a closed loop with a logo.

[Antonio Ciaccia @A_Ciaccia]

“CVS also has a structural edge” is such a formal and polite way to say “they can pay themselves more than their competitors.”

https://t.co/07J2bZxIMO

[Andrew @ajdezelan]

@PaulHFlowersJr 🔊

[Andrew @ajdezelan]

@Steve_Stuck They wouldn’t be working with him in the first place. He’s still a democrat. In a republican controlled quorum proof statehouse supermajority. Not happening

[Andrew @ajdezelan]

@bluedog373 @RobMKendall Maybe try an uncle. This is still indiana.

Rob still +1.

[Andrew @ajdezelan]

@bluedog373 @RobMKendall He voted for the democrat we count those twice where have you been brother

Rob still +1

[Andrew @ajdezelan]

@HandSurgeonMD Is it time for a chat about reference based pricing

[Andrew @ajdezelan]

@AndrewIrelandIN Which bill number was this

[Andrew @ajdezelan]

@txsportsdoc Strong take here

[Andrew @ajdezelan]

@PaulHFlowersJr Never. A PBM doesn't make money when prices drop. It makes money on the gap between what your plan pays and what the pharmacy gets. Cost Plus posts its markup. PBM contracts call theirs "confidential." For counties and cities, taxpayers are paying for that secret.

[Andrew @ajdezelan]

@mcuban @bot Claude is where we cook

[Andrew @ajdezelan]

I showed the dogs this thing and they totally forgot about the “we need your dogs DNA test to use our dog park” thing

[Andrew @ajdezelan]

@racheljanfaza Swingy is it? lol

[Peter H. Diamandis, MD @PeterDiamandis]

Every religion in history has promised miracles and warned of the apocalypse. Anthropic is the first to file both with the SEC.

[Andrew @ajdezelan]

I thought we would all just write in Abdul and call it a day

[Andrew @ajdezelan]

@jstewartIndy I got you

[Claude @claudeai]

New in Claude for Legal: a gallery of ready-made artifacts for contract review, regulatory horizon scans, cite checks, and more.

Start from the built-in example, add your own documents and connectors, and share it with anyone across the business.

[Andrew @ajdezelan]

@mcuban On point. Go Hoosiers