Author: Scott Welch
Medicare Advantage plans’ use of third-party algorithms for coverage determinations is facing some scrutiny in the Senate. Lawmakers in a Wednesday hearing argued something must be done to pare back burdensome prior authorization requirements allowing payers to delay or deny medical care that would be covered under traditional Medicare — including the use of artificial intelligence ...
House members participating in a Wednesday afternoon subcommittee hearing were in broad, bipartisan agreement that consolidation and other anticompetitive practices are prevalent across the healthcare industry and drive untenable costs for patients and the government. Based on their grab bag of witness questions and finger-pointing, however, it’s still up for debate which offending camp—pharmacy benefit ...
The Federal Trade Commission issued a warning Thursday about companies’ use of consumers’ biometric information such as facial recognition technology, saying it raises “significant consumer privacy and data security concerns.” Why it matters: The warning comes as a growing number of companies amass data based on individuals’ physiological features which could be used to infer consumers’ health or ...
Patient demand for GLP-1 weight loss drugs is continuing to grow, and, if Medicare were to expand coverage to meet that demand, it could cost the program billions each year, according to a new analysis. Traditional Medicare does not currently cover these drugs, which include brand names like Novo Nordisk’s Ozempic and Wegovy, for weight loss. ...
As artificial intelligence deployments increase in pace and scope in healthcare organizations around the globe, the World Health Organization this week issued a plea for vigilance and deliberation when it comes to how AI and machine learning models are put to use. WHY IT MATTERS The WHO called for “caution to be exercised” in how ...
Feeling down? Forget your usual comfort foods. Try eating your greens instead. Years of research underscores that eating more vegetables is not only good for your physical health, but it can improve mental health as well. It doesn’t take much. Even adding just one more serving of fruit or vegetables to your plate each day ...
A federal appeals court Monday partially paused a ruling from a Texas district court judge that jeopardized access to free preventive care for 150 million Americans.
Oscar Health will pull out of California’s individual market for the 2024 plan year, CEO Mark Bertolini told investors Tuesday. “We’re announcing today that we have decided to pause our participation in the California individual market for plan year 2024, as the plan has not met our targets,” Bertolini said on the insurtech’s earnings call. ...
California's budget deficit has grown to nearly $32 billion, Gov. Gavin Newsom announced Friday, saying the state's challenges are partly due to high federal inflation rates and the state's decision to let some people delay filing their taxes after winter storms.
A key Senate panel advanced a package of bipartisan bills aimed at improving generic drug competition and reforming the business practices of pharmacy benefit managers (PBMs).