Amid the growing use of artificial intelligence (AI) in the claims review cycle, this brief discusses the types of consumer protections for use of AI in prior authorization and claims review, describes the Trump administration’s general approach to AI , and highlights areas to watch as Congress considers AI legislation.
Starting in July, Medicare beneficiaries may be able to get a GLP-1 prescription for weight loss for $50 a month. It’s a notable shift for Medicare, which has long been barred from covering weight loss treatments. The drugs, such as Wegovy and Zepbound, are effective but can be expensive without insurance coverage. They’re available in…
The White House’s newly released strategy for tackling the nation’s drug and addiction crisis calls for a number of ambitious public health approaches that some experts say are laudable but will be hampered by the administration’s own actions. The sweeping 195-page National Drug Control Strategy, published May 4, advocates for making access to treatment easier…
This KFF Health Tracking Poll finds that the cost of health care is a more prominent focus for Make America Healthy Again (MAHA) voters than issues like food and vaccine policy. Four in ten MAHA voters (42%) choose lowering health costs as the most important health priority, outranking other MAHA priorities.
Chemical food additive and pesticide concerns associated with the Make America Health Again (MAHA) movement are shared broadly across the public. But when it comes to voters, health care costs are a higher priority and bigger motivator, even among MAHA supporters, a new KFF Health Tracking Poll finds.
Let’s say you’re the CEO of a health plan. A new drug just received approval to treat patients with lung cancer. The drug’s clinical trial examined how well the the drug worked on third line (3L) patients and patients with good funcional ability (e.g., performance status ECOG score of 0 or 1). FDA approved the…
Multiple federal agencies have signed a letter supporting prescribing practices
Disagreements between providers and payers have been moving into the courtroom over the past few weeks. The California Hospital Association sued Anthem over one of its out-of-network policies, Broward Health sued Florida Blue over alleged underpayment, and Jefferson Health sued Aetna over a Medicare Advantage hospital stay rule. The post Provider-Payer Tensions Brew in Courtrooms:…
Only 2 percent of UnitedHealthcare services currently require prior approval
Parsley Health is now in-network with major insurers nationwide, including UnitedHealthcare, Aetna and Cigna. The post Parsley Health Wins Greater Insurance Coverage for its Functional Medicine appeared first on MedCity News.