Medicare Advantage Insurers Overdeny Rehab Care, Often Reverse on Appeal
Biggest Medicare Advantage insurers denied rehabilitative care for older and disabled Americans at higher rates than industry peers, then frequently overturned those denials when patients appealed, OIG finds. Confirms reporting from @caseymross and me: https://t.co/PZG319GLwr
Trump Admin Forces Sick Poor to Prove Disability for Medicaid
The Trump administration wants low-income people who have cancer, kidney failure, and other complex conditions to prove they can't work in order to keep their Medicaid coverage. https://t.co/xLi06aZABv https://t.co/cZidVMqo7J
Massachusetts Sues UnitedHealthcare for Falsifying Seniors' Health
NEW: Massachusetts is suing UnitedHealthcare, alleging the company intentionally made low-income seniors appear sicker than they were over the past decade to boost its bottom line. https://t.co/sVFVjrDGfo
Longevity Experts Predict Lifespans Amid Organ Replacement Advances
So many incredible parts from this @SarahLizChar dispatch at a longevity conference, including organ replacement and her survey of how long these people think they'll live. https://t.co/2Pg55oXdV0 https://t.co/IpMq55atJB
Insurers Exit ACA Market When Enrollees Get Sicker
Cigna is abandoning the ACA health insurance marketplaces by the end of the year, following in Aetna’s footsteps. Insurers have shown, time and again, they will bail on the ACA market if people are too sick. @TaraBannow reports: https://t.co/kW6Cq06Haa
Hospital CEOs Flaunt Lobbying Clout in Congressional Testimony
Hospital CEOs are currently testifying in front on Congress. @ahahospitals just held its annual meeting, and @_daniel_payne caught this extremely candid quote from Chuck Schumer showing just how much lobbying power hospitals have. https://t.co/suwZZjZePb https://t.co/IHVq3JrVEF
UHC Reinstated Prior Authorization After Two Decades
More than 20 years ago, UnitedHealthcare was getting rid of prior authorization. But when Steve Hemsley first became CEO of UHC's parent company, he brought it back. https://t.co/suwZZjZePb https://t.co/6RnZH9dZvK
Labor Dept Demands PBM Payment Transparency Amid Legal Pushback
The Labor Department wants pharmacy benefit managers to disclose, for the first time, all the different ways they get paid. PBMs are warning this proposal is illegal. Supporters want the proposal to go further. The black box of Rx prices...
Trump’s Anti‑insurer Rhetoric Masks Policies Boosting Profits
The Trump administration has voiced some tough rhetoric about health insurers. But almost every major decision from Trump officials has benefited insurers and their bottom lines. The new Medicare Advantage rule is the latest example. https://t.co/ziGzSwknqK https://t.co/N3ACGahj3C
Trump Admin Boosts Medicare Advantage Bonuses, Adds $18.6B Cost
NEW: Trump admin is making it easier for Medicare Advantage plans to grab bonus $$ from star ratings. It'll cost taxpayers $18.6B over the next decade (more than the $13.2B originally expected). Will MA plans continue to cry poor? https://t.co/LPJsvb1Kck
UnitedHealth Slashes Disclosed Subsidiaries, Undermining Transparency Claims
Last year, UnitedHealth Group disclosed 3,100 subsidiaries. This year? Just 10. The health care giant is paring back transparency right as its executives say they are embracing it. https://t.co/Wp1TYSUKTa
Vaccine Pioneer Warns: We’re Heading Downhill.
Stanley Plotkin, known as the “godfather of vaccines,” in an interview with @HelenBranswell: “All I can say is that I’m beginning to regret having lived so long — because we’re going downhill.” https://t.co/A2zcoP2Ghd
CMS Plans AI‑Driven Overhaul of Medicare Enrollment Process
NEW: The entire process of finding Medicare coverage may be influenced by artificial intelligence in the not-too-distant future. CMS wants to use AI tools for its "Medicare Experience Modernization" project — and there are lots of question marks. https://t.co/uSLFlAxViJ https://t.co/2bP3HnEDBx