News
Medicare Advantage company pays $342 M to government in midst of billing probe
2+ hour, 59+ min ago (956+ words) A major Medicare Advantage company has paid the government more than $342 million to help settle allegations that it overcharged the federal healthcare program for years. Elevance Health, which covers about 2 million people on Medicare, sent the money to the Centers…...
Medicare's AI push snarls patients and doctors in errors and delays
5+ day, 3+ hour ago (1433+ words) In January, Oklahoma became one of six states to begin a pilot program testing the use of preapprovals in traditional Medicare, the federal health insurance program for people 65 and older or with disabilities. Bill Curry, 65, raises cattle on the same…...
To avoid care disruptions, know when the clock runs out on your prior authorization
3+ mon, 3+ week ago (1272+ words) Insurers require prior authorizations for certain treatments or tests, especially costly ones. A woman with multiple sclerosis wanted to be able to walk up the stairs at home without losing her balance. Her doctor prescribed medicine that helped, but then…...
These 3 policy moves are likely to change healthcare for older people
5+ mon, 3+ day ago (1388+ words) As with environmental law and consumer protections, the Trump administration's enthusiasm for deregulation has undone long-sought rules to improve care for the aged. Month after month, Patricia Hunter and other members of the Nursing Home Reform Coalition logged onto video…...
Sick of fighting insurers, hospitals offer their own Medicare Advantage plans
5+ mon, 2+ day ago (1187+ words) Although hospital-owned plans are only a sliver of the Medicare Advantage market, their enrollment continues to grow, reflecting the overall increase in Advantage members. Ever since Larry Wilkewitz retired more than 20 years ago from a wood products company, he's had…...
Kaiser Permanence to pay $556 million in record Medicare Advantage fraud settlement
5+ mon, 2+ week ago (820+ words) In the largest Medicare Advantage fraud settlement to date, Kaiser Permanente has agreed to pay $556 million to settle Justice Department allegations that it billed the government for medical conditions patients didn't have. The settlement, announced Jan. 14, resolves whistleblower lawsuits that…...
TBWA\World Health folding after strategic review; CEO Robin Shapiro departing Omnicom
11+ mon, 1+ week ago (486+ words) TBWA\World Health is merging into other Omnicom Health agencies following a strategic review. An Omnicom spokesperson confirmed that the 2025 MM+M Agency 100 honoree will soon be folded into sibling Omnicom Health units. "Omnicom has decided to merge TBWA\World…...