by Jordana Choucair | May 3, 2022 | Payers
UnitedHealthcare will limit coverage of Biogen Inc.’s Aduhelm across all of its plans starting June 1, saying it’s “unproven and not medically necessary for the treatment of Alzheimer’s disease due to insufficient evidence of efficacy.”...
by Jordana Choucair | Apr 29, 2022 | Payers
The Centers for Medicare & Medicaid Services (CMS) released a final rule that requires insurers on Affordable Care Act (ACA) exchanges to offer plans with standardized deductibles and limits on out-of-pocket costs and co-pays for each of non-standardized...
by Jordana Choucair | Apr 28, 2022 | Payers
According to a new report from Moody’s Investors Service, insurers have a significant opportunity to drive mental and behavioral health costs down. The report notes that private insurance accounts for 27.7 percent of emergency department visits across the five...
by Jordana Choucair | Apr 28, 2022 | Payers
The U.S. Health and Human Services Department Office of the Inspector General (OIG) released a report indicating that Medicare Advantage plans improperly deny millions of reimbursement claims and authorization requests for medically necessary care. The OIG found...
by Jordana Choucair | Apr 27, 2022 | Payers
The Kaiser Family Foundation released a new interactive providing key facts and trends about spending on Medicare. In 2020, Medicare benefit payments totaled $769 billion, representing 12 percent of the federal budget and 20 percent of national health care spending....
by Jordana Choucair | Apr 26, 2022 | Payers
Blue Cross Blue Shield of Michigan (BCBSM) and Honest Medical Group announced they are launching a joint venture that aims to make it easier for providers to transition to value-based care for Medicare patients. The venture aligns with BCBSM’s continued expansion of...
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