Author: Scott Welch
According to reporting by The Mercury News, one of California’s leading daily newspapers, about one-fourth of all health insurance claims in the Golden State were denied last year. Some may have been denied due to Artificial Intelligence (AI). However, new legislation prohibits health insurers from relying solely on AI to deny a claim based on medical necessity. ...
Last week, President Trump threatened tariffs on pharmaceuticals if manufacturers don’t relocate operations to the U.S. On Wednesday, the CEO of Eli Lilly stood with Trump’s commerce secretary in Washington, D.C., to announce a $27 billion plan to build four manufacturing “mega-sites” in the U.S. Why it matters: The commitment illustrates the dance much of Big Pharma is ...
Members of the U.S. House are rushing to update the federal law that governs preventive benefits coverage for people with health savings accounts. House leaders have put a bipartisan HSA preventive benefits bill, the Chronic Disease Flexible Coverage Act bill, on a list of items that could come to the House floor this week “under ...
As a measles outbreak in Texas has grown to nearly 150 cases, US Health and Human Services Secretary Robert F. Kennedy Jr. said in an opinion piece on Fox News on Sunday that parents should consult with health-care providers “to understand their options to get the MMR vaccine” for their children. Kennedy did not explicitly recommend the ...
Shortly before returning to the courtroom, Sutter Health has reached an “agreement in principle” to settle a long-running and recently revived antitrust class-action lawsuit, according to a Sunday evening legal filing and statement from the legal counsel for the plaintiffs shared Monday morning. The case, Sidibe et al v. Sutter Health, was filed in the ...
New evidence is highlighting just how important sleep is for overall health. Emerging research published in The Journal of Immunology found a link between sleep deprivation and the immune system, and the potential to develop obesity, diabetes and cardiovascular disease through inflammation. Researchers at the Dasman Diabetes Institute in Dasman, Kuwait, aimed to investigate how sleep quality impacts systemic ...
Republican leaders want to cut billions from Medicaid, but some of their colleagues are pushing back because they represent larger-than-average Medicaid populations, Kelly reports. A POLITICO review of enrollment in Medicaid by congressional district found that 11 Republicans in competitive seats represent larger-than-average Medicaid populations — collectively, nearly 2.7 million recipients. A vote to cut the ...
Proposed legislation could make California one of only a handful of states that require insurers to disclose denial rates and reasoning, which the industry often considers proprietary information.
As lawmakers scrutinize the nation's pharmacy benefit managers, the California insurer expects to save $500 million in annual drug costs by replacing most of CVS Health's PBM services by January 2025.
The Trump administration, perhaps surprisingly, chose to defend the legality of the Inflation Reduction Act’s (IRA’s) drug price negotiation program enacted under President Joe Biden. In a filing Feb. 19, the government agreed with the legal arguments used by the prior administration and by a lower court, dealing a blow to pharmaceutical drugmakers enraged by the program. ...