Author: Scott Welch
Millions of Americans in the past few years have run into this experience: filing a health care insurance claim that once might have been paid immediately but instead is just as quickly denied. If the experience and the insurer’s explanation often seem arbitrary and absurd, that might be because companies appear increasingly likely to employ ...
The letters from the insurance company arrived in recent weeks, bearing a warning to health care providers who prescribe Ozempic, a diabetes drug that has gained popularity as a weight-loss treatment. “The Special Investigations Unit has completed a comprehensive review of your prescription and professional claims,” said one letter to a Missouri doctor from insurer ...
Employers commonly ask brokers if they can offer a cash payment to an employee in lieu of paying for that employee’s benefits. This option is permitted, and it is referred to as a “cash in lieu of benefits” option (or a “pay in lieu of benefits” option). However, there are compliance aspects brokers need to ...
The Biden administration on Thursday announced a 10-year experiment aimed at improving the way Medicare and Medicaid pay for primary care. Why it matters: The effort, dubbed the Making Care Primary Model, will ease safety-net and independent primary care providers — including federally qualified health centers — into getting paid for the value of services they provide, rather than the volume. Remember: The ...
The Department of Health and Human Services (HHS) has released a 43-drug list of the Medicare Part B prescription treatments that must repay the program for raising prices above the rate of inflation. The second quarterly list takes effect in July and is an expansion over the 20 price-capped drugs from April through June. According ...
Consolidation has been the norm across healthcare for some time, and for those in the industry that want to stay independent, watching their peers unite can be intimidating. Chris Thomas is the president and CEO of Community Hospital, an independent hospital located in Grand Junction, Colorado. He told a key Senate panel on Thursday that ...
Too many Americans are losing Medicaid coverage because of red tape, and states should do more to make sure eligible people keep their health insurance, the Biden administration said Monday. More than a million Americans have lost coverage through the program for low-income and disabled Americans in the past several weeks, following the end of ...
A recent news report quoted a New Jersey Dental Association spokesman who warned, “Your routine dental treatment could be delayed for weeks or months because of our dental workforce shortages.” The mass exodus of dental hygienists and dental assistants began during the COVID-19 pandemic, leaving dentists short-staffed, overworked, and having to perform services usually accomplished by dental ...
Ultrasound technologist Georgette Bradford considers herself blessed. After 19 years with Kaiser Permanente, she’s not struggling to get by, or considering leaving the field for a more lucrative role at a less risky workplace. She says that sets her apart from many of her coworkers at Kaiser, and fellow members of the SEIU California union. ...
Fraudsters used the Social Security numbers of dead people and federal prisoners to get unemployment checks. Cheaters collected those benefits in multiple states. And federal loan applicants weren’t cross-checked against a Treasury Department database that would have raised red flags about sketchy borrowers.