Providers File The Bulk Of Medicare Appeals

This week, Robert F. Kennedy Jr sat before the Senate for 2 separate hearings, to decide the fate of his confirmation as secretary of HHS.

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

The high cost of incretin mimetics for weight management limits insurance coverage and potentiates variation in utilization management strategies to control near-term spending.

On this episode of Managed Care Cast, we speak with the author of a study published in the January 2025 issue of The American Journal of Managed Care® to examine the association between quantitative network adequacy standards and mental health care access among adult Medicaid enrollees.

Experts suggest that most Americans will not experience immediate changes in their out-of-pocket health care expenses.

Insurer-pharmacy benefit manager (PBM) firms control most of the Medicare Part D market, steering patients to their pharmacies through network exclusions and targeted marketing.