Nearly 50 million prior authorization requests were submitted to Medicare Advantage insurers on behalf of Medicare Advantage enrollees in 2023, of which 3.2 million (6.4%) were denied. Just 11.7% of denied requests were appealed, though 81.7% of appeals overturned the initial denial in Medicare Advantage. Substantially fewer prior authorization requests were made in traditional Medicare,…
It’s been a tumultuous past couple years for retail health companies —but there are still reasons to believe in the convenient model that retail health offers, said Annie Lamont, managing partner and co-founder of Oak HC/FT. The post Why One Investor Still Believes in Retail Health appeared first on MedCity News.
Swiss Medtech Company Medacta teamed up with Geisinger to begin providing the world’s first, lifetime guarantee on shoulder replacement surgeries. The post A Lifetime Guarantee on a Shoulder Implant? This Device Maker Is Offering It Through Geisinger appeared first on MedCity News.
Bringing care to people where they are improves community health outcomes — we must operate with more urgency to shore up care resources in rural areas. The post Closing the Rural Divide with Device-enabled Virtual Care appeared first on MedCity News.
Many insurers seem to be retreating from Medicare Advantage by exiting unprofitable markets and reducing benefits. This could be extremely disruptive to patients, experts warn. The post Insurers are Pulling Back on MA. How Does this Affect Patients? appeared first on MedCity News.
A next-generation Vertex Pharmaceuticals pain drug failed to beat a placebo in a Phase 2 clinical trial. Despite the disappointing outcome in bunionectomy pain, the company is continuing development of the oral drug in diabetic peripheral neuropathy. The post Vertex Non-Opioid Pain Drug Flunks Proof-of-Concept Test, Ending Plans for a Pivotal Study appeared first on…
How do you know a vendor handles data properly? Fortunately, independently-audited certifications can ease your concerns about a developer’s trustworthiness. The post Building Trust in Medical Software Development through Certifications appeared first on MedCity News.
After a year of ongoing measles outbreaks that have sickened more than 2,400 people, the United States is poised to lose its status as a measles-free country. However, the newly appointed principal deputy director at the Centers for Disease Control and Prevention, Ralph Abraham, said he was unbothered by the prospect at a briefing for…
Independent Health allegedly violated the False Claims Act by submitting invalid diagnosis codes to Medicare to inflate payments for its enrollees
Aggressive deportation tactics have terrorized farmworkers at the center of the nation’s bird flu strategy, public health workers say. Dairy and poultry workers have accounted for most cases of the bird flu in the U.S. — and preventing and detecting cases among them is key to averting a pandemic. But public health specialists say they’re…