Medicare is alleging laboratories improperly billed the government for improper tests; time is running out for children receiving healthcare from CHIP; the AMA extends its diabetes prevention model to Maryland and other states.
Taxpayer Losses to Medicare for Suspect Lab Tests Run Into Millions
Medicare is alleging laboratories improperly billed the government for unnecessary urine, genetic, or heart disease tests, which is expected to cause hundreds of millions dollars in losses to taxpayers, an investigation by Kaiser Health News found. But repayment is unlikely since at least 6 of the clinical labs are stuck in bankruptcy court. Medicare and also private insurers are taking a harder look at these tests as their costs have risen to about $8.5 billion a year.
Time Running Out for Low-Income Children on CHIP
Lawmakers have yet to agree on renewing federal funding for the Children’s Health Insurance Program (CHIP), which covers millions of children from low-income families, reported The New York Times. Federal funding expired on Sept. 30. States are getting ready to send out notices advising families that their care will be cut off next year unless lawmakers can come to an agreement about CHIP, which historically has had bipartisan support.
AMA Expands Diabetes Prevention Efforts to Maryland, Other States
Maryland becomes the latest state to work with the American Medical Association (AMA) in a multi-state effort to reduce type 2 diabetes. The AMA is partnering with MedChi, the Maryland State Medical Society, reported the Associated Press. Besides Maryland, the AMA added Maine, Mississippi, New York, Ohio, Oregon, Pennsylvania, and Rhode Island, joining California, Michigan, and South Carolina to its diabetes prevention model.
Despite Record ACA Enrollment, Report Reveals Underinsured Americans Are in Crisis
November 21st 2024Despite significant progress in expanding health insurance coverage since the Affordable Care Act (ACA) was enacted, millions of Americans still face critical gaps in access to and affordability of health care.
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Exploring Racial, Ethnic Disparities in Cancer Care Prior Authorization Decisions
October 24th 2024On this episode of Managed Care Cast, we're talking with the author of a study published in the October 2024 issue of The American Journal of Managed Care® that explored prior authorization decisions in cancer care by race and ethnicity for commercially insured patients.
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