Wednesday, May 4, 2022: Payers

A new report from the Robert Wood Johnson Foundation found that rural residents were the most likely to benefit from enhanced subsidies for Affordable Care Act (ACA) coverage and face the greatest danger of losing coverage if those benefits expire after this year. The...

Tuesday, May 3, 2022: Payers

UnitedHealthcare will limit coverage of Biogen Inc.’s Aduhelm across all of its plans starting June 1, saying it’s “unproven and not medically necessary for the treatment of Alzheimer’s disease due to insufficient evidence of efficacy.”...

Friday, April 29, 2022: Payers

The Centers for Medicare & Medicaid Services (CMS) released a final rule that requires insurers on Affordable Care Act (ACA) exchanges to offer plans with standardized deductibles and limits on out-of-pocket costs and co-pays for each of non-standardized...

Thursday, April 28, 2022: Payers

According to a new report from Moody’s Investors Service, insurers have a significant opportunity to drive mental and behavioral health costs down. The report notes that private insurance accounts for 27.7 percent of emergency department visits across the five...

Thursday, April 28, 2022: Payers

The U.S. Health and Human Services Department Office of the Inspector General (OIG) released a report indicating that Medicare Advantage plans improperly deny millions of reimbursement claims and authorization requests for medically necessary care. The OIG found...

Wednesday, April 27, 2022: Payers

The Kaiser Family Foundation released a new interactive providing key facts and trends about spending on Medicare. In 2020, Medicare benefit payments totaled $769 billion, representing 12 percent of the federal budget and 20 percent of national health care spending....