Whistleblower’s Claims About Medicare Advantage
A former official at UnitedHealth is asserting that big insurance companies are gaming Medicare Advantage, and have been doing so for years. The New York Times reported that a whistleblower described how companies gamed the system to make patients look sicker than they were in order to get more money from Medicare Advantage. The Department of Justice is taking the claims seriously and has said it intends to sue UnitedHealth Group and investigate other participants in Medicare Advantage.
Small Businesses Can Bypass HealthCare.gov
A new Trump administration rule change will allow small businesses to sign up for insurance through an agent or broker instead of HealthCare.gov. Currently, there are 85,000 people covered through the Small Business Health Options Program, which is far less than the millions expected when the program launched, reported The Hill. The rule change will take effect January 1, 2018, and businesses will still have to use HealthCare.gov to determine eligibility.
California Considers Protecting Family Planning Services
A new bill in California would allow patients to get care from the provider they are most comfortable with. According to California Healthline, the bill is being used to keep the federal rule that allows Medicaid patients to see the family planning provider they want, thus protecting access to Planned Parenthood and similar health clinics. The bill, which cleared the Senate Health Committee and now goes to the Senate Appropriations Committee, protects access even as the American Health Care Act that passed the US House of Representatives cuts federal funding for Planned Parenthood.
Disparities in Telehealth Access Undermine Adoption Among Patients With Schizophrenia
January 16th 2025The COVID-19 pandemic accelerated the widespread adoption of telemental health care, and new research indicates significant racial and ethnic disparities in access to this technology among Medicaid beneficiaries with schizophrenia.
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Study Suggests Postdischarge Care Needs Targeted, Multifaceted Approaches
January 15th 2025The findings challenge the effectiveness of these widely used transitional care interventions and suggest a need for more targeted, multifaceted approaches to address the needs of higher-risk patients.
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Frameworks for Advancing Health Equity: Pharmacy Support for Non-Hodgkin Lymphoma
December 19th 2024Rachael Drake, pharmacy technician coordinator, University of Kansas Health System, explains how her team collaborates with insurance companies and providers to support treatment access for patients with non-Hodgkin lymphoma.
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