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UPMC Demands Increased Cancer Payments From Highmark
UPMC is threatening to lock Highmark's Medicare Advantage customers out of its hospitals, a move Governor Tom Wolf calls "unacceptable."
The University of Pittsburgh Medical Center (UPMC) is threatening to lock Highmark’s Medicare Advantage customers out of its hospitals and clinics starting Jan. 1, a move Pennsylvania’s governor calls an “unacceptable” violation of UPMC’s commitment to keep senior citizens out of the crossfire between the 2 Pittsburgh health rivals.
UPMC, Pittsburgh’s largest hospital and physician network, has told the state it will make good on the threat unless Highmark, the state’s largest health insurer, agrees to increase cancer payments to the hospital system, and agrees to drop a lawsuit related to those oncology payments. About 182,000 Western Pennsylvania seniors have a Highmark Medicare Advantage policy, and if the dispute isn’t resolved in the next eight months, those seniors could lose in-network access to UPMC — unless they leave Highmark in favor of another insurance carrier.
Read the complete report by Pittsburgh Post-Gazette: http://bit.ly/1Ps6ZLM
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On 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.
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Neurologists Share Tips for Securing Patient Access to Gene Therapies
March 19th 2025Tenacious efforts at every level, from the individual clinician to the hospital to the state to Congress, will be needed to make sure patients can access life-saving gene therapies for neuromuscular diseases.
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Texas Oncology to Roll Out Canopy for ePROs After Head-to-Head Pilot
March 18th 2025Debra Patt, MD, PhD, MBA, executive vice president of Public Policy and Strategy for Texas Oncology, said the practice received positive feedback from nurses and patients during a pilot that concluded in February.
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Cancer Labels on Alcohol? Ireland, Where Pubs Still Rule, Will Have Them by Next Year
March 17th 2025As St. Patrick's Day brings global celebrations involving alcohol, Ireland looks forward to rethinking excess consumption with a new tool set to arrive next year: the world's most comprehensive alcohol warning label.
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