She Had To Fight For Help With Medical Bills. A New California Bill Could Make It Easier

A proposal advancing in the legislature would require California hospitals to pre-screen patients for charity care before sending out medical bills.

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2,300 DACA Recipients In California To Lose Health Insurance

More than 2,300 Californians enrolled in the Deferred Action for Childhood Arrivals program will lose their health insurance next month due to a change in federal policy, state officials announced Thursday.

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Medicare, Medicaid Plan To Experiment With Covering Weight Loss Drugs

The Trump administration is planning an experiment to cover weight loss drugs under Medicare and Medicaid, potentially benefiting millions of Americans struggling with obesity.

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HHS Locks In Health IT Rule To Advance Electronic Prior Auth, Real-Time Prescription Benefit Checks

The health IT arm of the Department of Health and Human Services finalized a rule this week that federal leaders say will remove red tape and enable faster prior authorization and real-time prescription benefit checks. The policy changes also will improve electronic prescribing standards, the agency said. The final rule, called the Health Data, Technology, ...

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PBM Market Dominated By Four Giants, Raising Concerns About Costs, Competition

The nation’s four largest pharmacy benefit managers control two-thirds of the market. This high concentration, along vertical integration between PBMs and insurers, may contribute to higher prices and lower reimbursement rates, according to a new report from the American Medical Association. “These are important findings, because low competition may lead to higher prices paid by ...

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UnitedHealthcare To Exit Certain Medicare Advantage Markets As Costs Balloon, Impacting 600K Enrollees

UnitedHealthcare CEO Tim Noel offered investors a deeper look at the medical cost spike that’s plaguing the insurance giant’s finances. He said during the company’s earnings call Tuesday morning that pricing assumptions set by the company “were well short of actual medical costs” for 2025. UHC’s current outlook, he said, instead reflects an additional $6.5 ...

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