US Hospitals See Post Pandemic Catch-Up Behind Insurer Healthcare Costs

Americans are catching up on healthcare missed during the COVID-19 pandemic, a trend driven by heart procedures and outpatient orthopedic surgeries that likely won’t soon slow, according to interviews with three hospital officials in major U.S. cities, but other factors may also be at play. U.S. health insurers have warned of high demand for medical ...

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Patients See First Savings From Biden’s Drug Price Push, as Pharma Lines Up Its Lawyers

Last year alone, David Mitchell paid $16,525 for 12 little bottles of Pomalyst, one of the pricey medications that treat his multiple myeloma, a blood cancer he was diagnosed with in 2010. The drugs have kept his cancer at bay. But their rapidly increasing costs so infuriated Mitchell that he was inspired to create an ...

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New Eligibility Rules Are a Financial Salve for Nearly 2 Million on Medi-Cal

Millions of Medi-Cal beneficiaries can now save for a rainy day, keep an inheritance, or hold on to a modest nest egg, without losing coverage, thanks to an eligibility change phased in over the past year and a half. It also has opened the door for thousands who previously did not qualify for Medi-Cal, the health insurance ...

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CAA Pharmacy Rx Data Collection (RXDC) Compliance Requirements Due By 6/1

The Consolidated Appropriations Act (CAA) of 2021 introduced a web of transparency-related regulations and compliance items for health plans, insurance issuers, agents, and providers – all intending to improve clarity and accountability in health care. The CAA prioritizes transparency in health care by requiring annual reports from plans and insurance issuers on prescription drug costs and overall ...

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CAA 2023 Prescription Drug Data Collection (RXDC) Carrier Reference

The Consolidated Appropriations Act (CAA) of 2021 created a myriad of new compliance requirements for health plans and insurance issuers, aiming to increase “transparency” in health care. One key requirement is the Rx Data Collection (RxDC), which requires plans and issuers to report on prescription drug and health care spending for the 2023 calendar year by ...

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NABIP’s CEO Jessica Brooks-Woods Spearheads AI Revolution in Health Insurance, Pioneering Health Equity and Innovation

The National Association of Benefits and Insurance Professionals (NABIP) proudly announces a series of groundbreaking initiatives under the leadership of CEO Jessica Brooks-Woods, the first Black female CEO in the association’s history. With a visionary approach, she is steering NABIP towards harnessing artificial intelligence (AI) to revolutionize health insurance selection and champion health equity, marking a ...

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Surprise Billing Disputes Continue To Far Outpace Federal Estimates: CMS

The number of balance billing disputes reaching arbitration is far higher than federal projections suggested, according to new data from the Biden administration. The Centers for Medicare & Medicaid Services (CMS) issued a report this week looking at the number of surprising billing negotiations that reached the independent dispute resolution (IDR) phase of the No ...

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Artificial Intelligence Is Making Critical Health Care Decisions. The Sheriff Is MIA.

Doctors are already using unregulated artificial intelligence tools such as note-taking virtual assistants and predictive software that helps them diagnose and treat diseases. Government has slow-walked regulation of the fast-moving technology because the funding and staffing challenges facing agencies like the Food and Drug Administration in writing and enforcing rules are so vast. It’s unlikely ...

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Do I Really Need An Annual Physical?

Is your annual physical a waste of time? A growing number of physicians say the value of a yearly physical depends in part on your age and health history, and that some young, healthy patients can afford to skip it. Some studies have suggested that the annual visits aren’t doing much to improve our long-term ...

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Nevada State Senator Files Suit To Scuttle Public Health Care Insurance Option

Nevada State Sen. Robin Titus, R-Wellington, along with the National Taxpayers Union, filed a lawsuit over the constitutionality of legislation passed to bring a state-managed public health care insurance option to Nevada. The suit was filed in Nevada’s First Judicial District Court in January challenging Senate Bill 420, passed during the 2021 legislative session. “My ...

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