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To Prevent Surprise Bills, New Health Law Rules Could Widen Insurer Networks
The Obama administration and state insurance regulators are developing stricter standards to address the concerns of consumers who say that many health plans under the Affordable Care Act have unduly limited their choices of doctors and hospitals, leaving them with unexpected medical bills.
The Obama administration and state insurance regulators are developing stricter standards to address the concerns of consumers who say that many health plans under the Affordable Care Act have unduly limited their choices of doctors and hospitals, leaving them with unexpected medical bills.
Federal officials said the new standards would be similar to those used by the government to determine whether Medicare Advantage plans had enough doctors and hospitals in their networks. These private plans, sold by companies like UnitedHealth and Humana, provide comprehensive care to 16 million of the 54 million Medicare beneficiaries.
States are free to adopt additional standards of their own, and Washington did so in late April.
Read the full story here: http://nyti.ms/1nNTWmu
Source: The New York Times
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September 17th 2025Syndromic reverse transcriptase–polymerase chain reaction tests for respiratory infections were associated with lower health care resource utilization and costs, implicating potential for improved value in patient care.
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AI in Health Care: Balancing Governance, Innovation, and Trust
September 2nd 2025In this conversation with Reuben Daniel, associate vice president of artificial intelligence at UPMC Health Plan, we dive into how UPMC Health Plan builds trust with providers and members, discuss challenges of scaling AI effectively, and hear about concrete examples of AI's positive impact.
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