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White House Orders Broader Obamacare Health Plans in 2015
The Obama administration is requiring health plans in Obamacare insurance marketplaces to include a more robust offering of care providers in 2015 after some early backlash over limited networks in the health care law's first year.
The Obama administration is requiring health plans in Obamacare insurance marketplaces to include a more robust offering of care providers in 2015 after some early backlash over limited networks in the health care law's first year.
Health plans selling on the federal marketplaces in 2015 must include 30 percent of area "essential community providers," which are usually health centers and other hospitals serving mostly low-income patients. That's up from a 20 percent requirement in 2014, the first year of expanded overage under the health care law.
The federal Centers for Medicare and Medicaid Services, which oversees the marketplaces, will also take a much more active role in reviewing health plan networks. CMS, which outlined the new standards in a Friday night letter to insurers, will evaluate whether the plans include enough access to hospitals, primary care doctors, mental health providers and oncologists.
Read the full story here: http://wapo.st/PIriua
Source: The Washington Post
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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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.
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Drug Interactions With Ibrutinib Common, Linked to Higher Infection Risk in CLL
September 16th 2025Drug interactions with ibrutinib may not shorten survival when managed carefully, though the significant increase in infection-related hospitalizations tied to CYP3A inhibitors signals an urgent need for closer monitoring, dose adjustment, and proactive infection prevention strategies.
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