The Affordable Care Act (ACA) established the Patient-Centered Outcomes Research Institute (PCORI) to fund research into the effectiveness, benefits, and harms of various medical treatments and interventions. This research is funded in part by the PCORI fee – an annual fee paid by: Health insurance carriers on fully insured medical plans, and Employers that sponsor self-funded medical plans (including ...

Effective July 1, 2025, Optum Rx is removing reauthorization for more than 60 drugs that treat chronic conditions. The newly added medications include treatments for seven chronic conditions, such as behavioral health, HIV, dry eye disease, high cholesterol and hypertension. “Chronic conditions affect about 60% of Americans and are the leading cause of death in ...

UC Health and Blue Shield of California, which are at an impasse over the terms of a new contract that could disrupt health care for thousands of Californians, have extended the deadline for reaching a new agreement from July 9 to Aug. 9. This means the thousands of Californians who get medical care at UC ...

Blue Shield of California is cutting broker commissions for new enrollments into Medicare Advantage PPO plans in Alameda, Orange and San Diego counties, effective July 1. The new policy does not affect commission payments of existing membership, according to a June memo sent to brokers. Several large insurers have cut MA commissions recently, including UnitedHealthcare, Elevance Health ...

The Supreme Court upheld a key preventive services task force in a 6-3 ruling issued Friday morning. The high court determined that members of the U.S. Preventive Services Task Force, which makes recommendations for coverage requirements under the Affordable Care Act, are selected within the bounds of the Constitution. In the case, Braidwood Management, an ...

In 2025, nearly 4 in 10 people said they worried about being able to afford their medications, up significantly from 27% in 2024.