Month: September 2024
Medicare Advantage plans have been successful in enrolling Medicare beneficiaries and delivering to those clients. Despite this, some insurers are downsizing their share of the market and hospitals are canceling or not renewing their contracts to serve plan members – leaving enrollees in the lurch. In recent months, Humana, CVS and some smaller insurers announced ...
California Gov. Gavin Newsom will soon decide whether the most populous U.S. state will join 25 others in regulating the middlemen known as pharmacy benefit managers, or PBMs, whom many policymakers blame for the soaring cost of prescription drugs. PBMs have been under fire for years for alleged profiteering and anticompetitive conduct, but efforts to ...
A growing number of U.S. adults are hesitant to get recommended vaccines this fall, a new survey found. The poll, which included 1,006 people, found that only 43% of respondents have gotten or plan to get the COVID vaccine. Only a slight majority (56%) of adults said they have gotten or plan to get the flu shot this ...
More than 50 years after the Employee Retirement Income Security Act (ERISA) was signed into law, a House hearing Sept. 10 delved into ways to protect and improve the legislation. Expert witnesses emphasized the importance of the law and legislation they think would bolster the underlying strength of ERISA. Lawmakers and witnesses approved of ERISA ...
Beyond their calls for increased outpatient payments, hospitals are urging the Biden administration to reconsider a plan for new care requirements that they say would “inadvertently reduce access to vital obstetrical services.” In July, the Centers for Medicare and Medicaid Services (CMS) released its Calendar Year 2025 Outpatient Prospective Payment System (OPPS) and ASC Payment ...
There are lots of good reasons to exercise that have nothing to do with weight loss. Now, science has found yet another one: It turns out that a regular exercise habit can make your fat tissue healthier. And that, in turn, keeps you healthier. To find out how exercise impacts fat tissue, researchers at the University ...
The Biden administration announced a final rule on Monday meant to expand access and lower costs for care for mental health and substance use disorders. Most provisions in the rule will apply to group health plans and health insurance issuers for plan years starting January 1 or after. Under this rule, mental health and substance use ...
At least two in five U.S. adults — or more than 57 million people – under the age of 65 with “private insurance could be eligible under clinical criteria for GLP-1 drugs,” a new analysis shows. KFF, formerly known as the Kaiser Family Foundation, said that 42% of U.S. adults could be covered by health insurers ...
Local pharmacies and patient groups like it. Health insurance and benefits groups predict it will drive up costs.
Even as federal aid poured into state budgets in response to the covid-19 pandemic, public health leaders warned of a boom-and-bust funding cycle on the horizon as the emergency ended and federal grants sunsetted. Now, that drought has become reality and state governments are slashing budgets that feed local health departments.