UnitedHealth Group’s multibillion-dollar pharmacy benefit manager, Optum Rx, is suing five Kentucky counties in an attempt to force them out of national opioid litigation against the company. Pharmacy benefit managers, often called PBMs, act as middlemen that negotiate prescription drug prices between drug companies, insurance plans, and pharmacies. Some lawyers and advocates say PBMs helped…
In his return to the White House this week, President Donald Trump issued a flurry of executive orders on immigration, including declaring an emergency at the U.S.-Mexico border, suspending refugee admissions, and calling to roll back birthright citizenship. His administration rescinded a long-standing policy not to arrest people without legal status at or near sensitive…
Try a variety of LLM-based tools yourself. Understand the risks, limitations, and who is working on putting quality frameworks and guardrails in place. Engage your employees and partners in discussions about what might now be possible. The post A CEO’s Guide to AI Exploration: Transforming Organizations and Mindsets appeared first on MedCity News.
Nearly three in four adults enrolled in Medicaid have one or more chronic conditions. Medicaid spending doubles for adults with 1-2 chronic conditions and quadruples for those with 3 or more chronic conditions. Low or no out-of-pocket costs for prescription medications in the Medicaid program help adults with chronic conditions avoid cost-related rationing or delays…
The Department of Justice has reached a proposed settlement with UnitedHealth Group and Amedisys regarding UnitedHealth’s acquisition of the home health provider, which includes the divestiture of 164 home health and hospice locations. The post DOJ: UHG, Amedisys Must Divest 164 Locations for Acquisition to Proceed appeared first on MedCity News.
When it comes to the effects that the upcoming Trump presidency will have on healthcare, attendees’ attitudes ranged from cautiously optimistic to fairly anxious. Some of the issues they highlighted included mental health parity, telehealth prescribing flexibilities, and the role of Robert F. Kennedy Jr. The post How Did Attendees at a Behavioral Health Conference…
The application of AI technology is part of a carefully orchestrated effort dependent on human intelligence, and the collaboration of physicians, disease-specific specialists, nurses, data scientists, and technologists. Done right, these efforts can lead to profound benefits, and offer a promising future for clinical research and patient care. The post Augmenting Brain Power: Real-World Data, Advanced…
Stacey Knoll thought the court summons she received was a scam. She didn’t remember getting any medical bills from Montrose Regional Health, a nonprofit hospital, after a 2020 emergency room visit. So she was shocked when, three years after the trip to the hospital, her employer received court orders requiring it to start funneling a…
Kim Beckham, agente de seguros en Victoria, Texas, había visto a sus amigos sufrir tanto por la culebrilla (shingles) que quería recibir la primera vacuna aprobada contra esta infección tan pronto como estuviera disponible, incluso si tenía que pagarla de su bolsillo. Su médico y varias farmacias le dijeron que no podían administrarle la vacuna…
More effective and proactive care requires a framework that will enable the U.S. healthcare system to better meet the inevitable challenges of an aging population and pave the way for a sustainable and equitable future. Monitoring and other digital health enabled tools are helping to build that framework by offering a new medium for care…