California’s Medicaid program, Medi-Cal, is slashing asset limits 84% in July 2027. As a result, Medi-Cal members risk losing eligibility — and insurers are feeling the pressure. In 2022, California lifted the asset limit from $2,000 to $130,000 for individuals. CMS eventually approved a state proposal to drop the asset test, but California resurfaced the limits at the beginning of 2026. The 2027 ...
Thomas Zordani flew from his home in Denver to Phoenix for a consultation with a Mayo Clinic neurosurgeon, hoping to find out what could be done to treat his debilitating headaches after worrisome brain scan findings. When making the appointment, Zordani said, he’d been told the clinic was in his insurer’s network. Upon arrival, Zordani ...
A federal appeals court on Tuesday struck down a formula used by healthcare providers, insurers and the government that is designed to shield patients from staggeringly high “surprise” medical bills. In an unsigned decision, a majority of the 17-judge 5th U.S. Circuit Court of Appeals in New Orleans assured the ruling would not lead to ...
A health care advocacy group on Thursday sued the American Medical Association in an effort to get more transparency over the association’s billing codes, which guide billions of dollars in health care payments. PatientRightsAdvocate.org hopes to republish the codes online and allow the public to search them free. The group, which has pushed for health care ...
SCAN Health Plan and Costco will roll out insurance products for older adults in the coming years, according to an Aug. 18 news release. The Wall Street Journal reported that the companies would begin by selling jointly branded Medicare Advantage products in two states, as well as a Medicare supplement in a third state. While the geography was ...
The Pharmaceutical Care Management Association announced Thursday that its members had reached an agreement with the feds to offer information on cash prices available through TrumpRx. The commitment encompasses nine of the industry’s leading pharmacy benefit managers, including the “Big Three” in CVS’ Caremark, UnitedHealth Group’s Optum Rx and Cigna’s Express Scripts. Other participants that have signed ...