Survey: 13% Of Medicare Advantage Claims, Prior Authorization Requests Denied

A recent survey of Medicare Advantage enrollees found 13% had a claim or pre-authorization request denied as the program has gotten scrutiny over its prior authorization practices. The survey, released Monday by the online insurance marketplace eHealth, also found that 67% of respondents chose MA over Medigap due to concerns over its affordability. The MA ...

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COVID Hospitalizations Grow, But Drop In Cases May Be Misleading

COVID-19 hospitalizations continue to inch up in Clark County and in Nevada, even as one metric shows confirmed cases dipping, though officials caution that the growing use of at-home tests is leading to undercounts.

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Nevada’s Exchange Promotes Two Long-Time Employees to Leadership Roles

Two long-time employees have been promoted at the state agency, The Silver State Health Insurance Exchange (Exchange), including Janel Davis as new Chief Operations Officer (COO) and Katie Charleson as the new Communications Officer.

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New Drug Prices Soar To $180,000 A Year On 20% Annual Inflation

While gasoline and food prices soar, few products rival the inflation in prices on newly launched prescription drugs, according to a new study.

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The Paw-Ful Truth: These Are The Biggest Pet Claims Of 2021

At the end of 2020, more than 3 million pets were insured in North America. According to the most recent report from the North American Pet Health Insurance Association, that number increased to 4.41 million in 2021. In the United States, there was a 28.3% increase in total pets insured in 2021, with an average ...

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Providers Are Calling For More Time To Implement Estimate Requirement In Surprise Bill Rule

Providers have a little more than six months to find a way to deliver good faith estimates to patients on medical bills, but some say a lack of automated solutions is going to create a colossal burden for them to meet. Several groups have written to the Centers for Medicare & Medicaid Services (CMS) asking ...

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Price Transparency Noncompliance Rampant, Especially In Concentrated Markets, Rural Areas

Hospitals located in more concentrated healthcare markets, rural hospitals and those with higher per patient-day revenue could require “greater scrutiny” to ensure compliance with federal price transparency rules, according to a new analysis. The warning comes alongside yet another review of hospital websites finding low industrywide adherence to the mandate, which requires hospitals to post ...

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Mask Rules Are Suddenly Back In California As Coronavirus Hits Danger Zone

Suddenly, California officials are moving toward new indoor mask rules as coronavirus cases enter the danger zone in many parts of the state.

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Here’s How Many People Are Quitting Their Jobs in California

In what has been dubbed the Great Resignation, Americans have been quitting their jobs in record numbers in recent months - a trend that shows no signs of slowing. According to the Bureau of Labor Statistics, over 4.5 million Americans quit their job in March 2022, the most ever recorded in a single month, and up from 4.4 million quits in February.

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California Wants to Slash Insulin Prices by Becoming a Drugmaker. Can it Succeed?

California is diving into the prescription drug business, attempting to achieve what no other state has done: produce its own brand of generic insulin and sell it at below-market prices to people with diabetes like Sabrina Caudillo.

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