CMS Won't Expand Dual-Eligibles Pilot Program

Richard Hughes IV, JD, MPH, spoke about the upcoming oral arguments to be presented to the Supreme Court regarding the Braidwood case, which would determine how preventive services are guaranteed insurance coverage.

On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.

The California-based entities plan to offer new Medicare Advantage (MA) products in select counties by this fall.

The annual wellness visit is beneficial for patients, providers, and payers with an emphasis on preventive care for early intervention.

This study examined postdiagnosis breast cancer treatment outcomes for Medicare Advantage vs fee-for-service (FFS) Medicare in Ohio and found no significant differences overall but disparities for Black patients with FFS Medicare.

Prior authorizations create substantial administrative and financial burdens on physicians and patients and can disrupt the continuity of care.