Appeals court to review ruling wiping out some cost-free preventative services; a new legislation aims to boost reimbursement rates for medical providers; changes to coverage may limit elderly home care access
Appeals Court Reviews Ruling Out Cost-Free Preventive Services
The 5th US Circuit Court of Appeals will hear arguments in the case over a provision that requires insurers cover preventive care services at no costs to patients, under an Affordable Care Act (ACA) mandate, according to CNN. The court is set to review a Texas judge’s ruling that wiped away that requirement, which is currently paused until under the verdict of the appeals court. The decision is likely to have far-reaching implications for both health care policy and the ongoing debate over the future of the ACA.
Doctors Applaud Proposed Medicare Pay Increase
Starting March 9, 2024, doctors will receive a 1.68% pay increase from Medicaid under a new deal struck over the weekend by Congress, according to Stat. The proposed legislation seeks to address longstanding concerns about low payment rates and reforms for the practice of using pharmacy benefit managers. If passed, the bill could improve access to care for Medicare beneficiaries and help alleviate financial strains on medical practices nationwide.
MA Plans Set to Impose Limits on Home Health Services
Medicare Advantage (MA) plans are poised to restrict access to home health services, sparking worries among elderly populations, according to Axios. A recent study in JAMA Health Forum found that patients with MA plans had less home health care and worse outcomes than those on Medicare. Advocates fear that such changes may exacerbate health disparities for those who are likelier to live alone with less care and often don’t need care until they are in dire medical situations.
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.
Listen
Infertility Coverage Boosts ART Use and Pregnancy Success: Richard A. Brook, MS, MBA
August 26th 2025In this episode, Richard A. Brook, MS, MBA, discusses his study showing that infertility treatment coverage increases assisted reproductive technology (ART) use and improves pregnancy outcomes.
Listen
Stagnation in Reimbursement Keeps Biomedical Innovation From Reaching All Patients, COA Panel Says
September 9th 2025Panelists at the Community Oncology Alliance Payer Exchange Summit discuss the urgent need for innovative reimbursement models in cancer care to match advancements in biomedical technology and drug discovery.
Read More