News
A suspicious denial pattern in Medicare Advantage
3+ hour, 14+ min ago (122+ words) statnews. com For those interested in peptides, stem cells, supplements, red light treatments, hyperbaric chambers, body vibration devices, or getting ion balances through walking barefoot " RFK'Jr. s most recent podcast might be worth a listen. Send news tips and wellness…...
Private Medicare plans erect barriers to rehab care in pursuit of profit, federal investigators find
14+ hour, 9+ min ago (213+ words) Ross and Herman have been investigating denials of rehabilitative care by large health insurers for three years. They previously published an investigation into insurers" reliance on Navi Health to scrutinize these requests, which was a finalist for a Pulitzer Prize....
Medicare's mum on GLP-1s, and Massachusetts sues United
1+ week, 3+ day ago (246+ words) Hello, and all hail Chonkers! Get your Alice Cooper voice ready, because school's out for summer. But HCI is open year-round, so tell me all about your summer plans and any juicy intel you have on the health care industry:…...
Massachusetts sues United Health, alleging fraud in state's Medicaid plans for seniors
1+ week, 6+ day ago (151+ words) Bob Herman is the author of Health Care Inc. , an award-winning weekly newsletter about the business of health and medicine. Massachusetts Attorney General Andrea Joy Campbell is suing United Health Group's insurance subsidiary, United Healthcare, alleging the company intentionally made…...
Elevance executive ordered to testify in Medicare Advantage fraud case
3+ week, 3+ hour ago (193+ words) Peter Haytaian, a former top executive at health insurance company Elevance Health, will have to sit for a deposition in the federal government's case that alleges Elevance committed fraud in its Medicare Advantage plans, a judge ruled late Wednesday. The…...
Congressional Democrats try to force a vote to end Medicare AI prior authorization pilot
3+ week, 22+ hour ago (481+ words) Senate and House Democrats introduced resolutions Wednesday to overturn a Medicare pilot that uses artificial intelligence to approve or deny care. The technology experiment has led to allegations of delayed care for seniors in at least one of the six…...
Medicare's miss on Alzheimer's drug spending
1+ mon, 7+ min ago (240+ words) Bob Herman is a business of health care reporter at STAT. He covers hospitals, health insurance, and other corners of the industry " with a goal of explaining and shining light on the massive amount of money flowing through the system....
DOJ, Elevance spar over access to top exec in Medicare Advantage fraud case
1+ mon, 1+ week ago (244+ words) Bob Herman is a business of health care reporter at STAT. He covers hospitals, health insurance, and other corners of the industry " with a goal of explaining and shining light on the massive amount of money flowing through the system....
Federal test of AI prior authorization is delaying care for seniors, report says
1+ mon, 2+ week ago (308+ words) Washington state hospitals say their Medicare patients are waiting two to four times longer in some cases for procedures that are now subject to prior authorization under a new Medicare program." The report from U. S. Sen. Maria Cantwell (D-Wash.) is among…...
Medicare Advantage plans win extra $18. 6 billion as feds cut star ratings measures
2+ mon, 1+ week ago (537+ words) Bob Herman is a business of health care reporter at STAT. He covers hospitals, health insurance, and other corners of the industry " with a goal of explaining and shining light on the massive amount of money flowing through the system....