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AMERICA OUT LOUD PODCAST NETWORK

The hidden cost of care PBMs, carve-outs, and denied treatment

AMERICA OUT LOUD PODCAST NETWORK

AMERICA OUT LOUD PODCAST NETWORK

News, Society & Culture, Politics

4.7527 Ratings

🗓️ 1 May 2026

⏱️ 58 minutes

🧾️ Download transcript

Summary

The Nurses Report on America Out Loud with Ashley Caputo, RN, FMP – This episode of The Nurses Report explores how Pharmacy Benefit Managers shape access to medications, often leading to delays and denials. It examines carve-outs, ERISA limits, and real patient impacts while highlighting the growing need for transparency, advocacy, and patient-centered decision-making in today’s healthcare system...

Transcript

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0:00.0

Welcome to the untold.

0:09.0

Take a deep breath, take the higher road.

0:13.0

That's what they always say,

0:15.0

as if they know the way they won't take it from me.

0:20.0

But don't ever doubt yourself as life in just a dream

0:23.6

You made your own so kick and scream

0:27.6

The people will act with a never-ending force

0:30.6

You never had the chance so what you're waiting for

0:34.6

The day has come my, because this is what.

0:57.4

Welcome back to The Nurses Report on America Out Loud. I'm your host, Ashley Computo, registered nurse, and functional medicine practitioner.

1:03.0

Today's episode, it's kind of spinning off of what we talked about last week, but it's something

1:09.4

that impacts millions of Americans, and most

1:12.6

people have just never heard of it. So today we're going to dive more into pharmacy benefit

1:18.7

managers or PBMs and something called carveouts. And these are entities quietly controlling

1:26.6

what medications you can get, when you can get them,

1:30.3

and sometimes whether you get them at all.

1:33.5

And we're going to walk through exactly how this system works and how it impacts real patients.

1:40.6

I'm joined today again by Amy Whitlock, who's experiencing firsthand through a case involving a

1:48.2

specialty pharmacy carve out trying to get her son's medication.

1:52.6

Amy, I'm so glad you're here with us today.

1:55.1

Thank you.

1:56.1

Thank you.

...

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