The health IT arm of the Department of Health and Human Services finalized a rule this week that federal leaders say will remove red tape and enable faster prior authorization and real-time prescription benefit checks. The policy changes also will improve electronic prescribing standards, the agency said. The final rule, called the Health Data, Technology, ...

The nation’s four largest pharmacy benefit managers control two-thirds of the market. This high concentration, along vertical integration between PBMs and insurers, may contribute to higher prices and lower reimbursement rates, according to a new report from the American Medical Association. “These are important findings, because low competition may lead to higher prices paid by ...

UnitedHealthcare CEO Tim Noel offered investors a deeper look at the medical cost spike that’s plaguing the insurance giant’s finances. He said during the company’s earnings call Tuesday morning that pricing assumptions set by the company “were well short of actual medical costs” for 2025. UHC’s current outlook, he said, instead reflects an additional $6.5 ...

Some dental insurance issuers might be attracting employer customers with first-year prices that are too low to last. Amy Friedrich, president of the Benefits & Protection business at Principal Financial Group, talked about dental plan competition earlier this week during a conference call with securities analysts. “We are definitely seeing new-sales rates that are competitive,” Friedrich said. ...

The Trump administration is now accepting applications for a pilot program to demo rebates for 340B drugs that drugmakers have said are necessary to reduce abuse of the decades-old subsidy program. Announced Thursday by the Department for Health and Human Services (HHS) Health Resources and Services Administration (HRSA), the pilot would swap out traditional upfront ...

The prior authorization process is in the spotlight as the majority of Americans say delays and denials of services and treatments by health insurance companies are a major problem. This sentiment is shared across demographic groups, political affiliations and income levels, according to a KFF survey. About half of insured adults have had to get ...