Nearly Half Of Insured Americans Get Surprise Expenses In Medical Bills, Survey Finds.

Nearly half of Americans with health insurance said they received a recent medical bill or a charge that “should have been free or covered by their insurance,” according to a survey released Thursday. The survey, from the Commonwealth Fund in New York City, found 45% of working-age consumers last year were erroneously billed, however, fewer than half ...

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CMS Finalizes 2.9% Pay Bump For Inpatient Hospitals In FY2025

The Biden administration has finalized proposed payment rates for inpatient services in the coming year, and they’re not likely to be welcomed by hospitals. Initially, the Centers for Medicare & Medicaid Services (CMS) proposed a 2.6% payment increase for 2025, which providers decried as inadequate. In the final Inpatient Prospective Payment System (IPPS) rule, that ...

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Cigna CEO David Cordani Defends PBMs As Scrutiny Of The Industry Ramps Up

Cigna CEO David Cordani mounted a defense of pharmacy benefit managers during the company’s earnings call on Thursday morning as regulators and critics turn up the heat on the industry. Cigna owns Express Scripts, which along with CVS’ Caremark and UnitedHealth Group’s Optum Rx, dominate the PBM space. Cordani said that pharmacological innovation is a ...

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Amazon Projected $1B In 2024 Health Care Losses: Report

Amazon is still so enthusiastic about the idea of expanding its health care operations that it accepted $1 billion in projected 2024 health care losses back in December, according to Eugene Kim of Business Insider. Kim reported, based on internal documents, that Amazon also projected that health care unit revenue would increase 30%, to $3 ...

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‘Game Changer’ AI Detects Hidden Heart Attack Risk

Technology that identifies people at risk of a heart attack in the next 10 years has been hailed as “game changing” by scientists. The artificial intelligence (AI) model detects inflammation in the heart that does not show up on CT scans, which involve a combination of X-rays and computer technology. A pilot project, supported by ...

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Part D National Average Bid Amount To Increase To $179.45 In 2025

The government subsidy to Part D plans is shifting from being reconciled on the backend to a larger risk-adjusted payment upfront.

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Premiums For Covered California Insurance Will Go Up In 2025. Here’s How Much

Premiums for health insurance sold through the state’s marketplace will increase by nearly 8% in 2025, Covered California officials announced Wednesday.

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ACA Exchange Enrollees Could See Steep Premium Increases If Enhanced Subsidies Expire: KFF

The enhanced subsidies available for Affordable Care Act plans have been the key to driving massive enrollment growth, and rolling them back would likely lead to a massive spike in premium payments, according to a new report.

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Why Many Nonprofit (Wink, Wink) Hospitals Are Rolling in Money

One owns a for-profit insurer, a venture capital company, and for-profit hospitals in Italy and Kazakhstan; it has just acquired its fourth for-profit hospital in Ireland. Another owns one of the largest for-profit hospitals in London, is partnering to build a massive training facility for a professional basketball team, and has launched and financed 80 for-profit start-ups. Another partners with a wellness spa where rooms cost $4,000 a night ...

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CMS Announces New ‘Premium Stabilization’ Program

The Centers for Medicare & Medicaid Services (CMS) is creating a voluntary demonstration program to support changes to Medicare Part D under the Inflation Reduction Act (IRA). The agency also finalized bid information for contract year 2025, with a base beneficiary premium increase of $2.08 for people with Part D. The IRA is designed to ...

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