Governor Approves Bill to Reduce Prior Authorization Hassles
Care for countless Texas patients will happen more quickly by reducing health insurers ’ bureaucratic delays, thanks to a bill Gov. Greg Abbott allowed to become law this weekend.The Texas Medical Association (TMA) prioritized curbing health insurers ’ onerous prior authorization practices this legislative session, resulting in passage of House Bill 3459 by Rep. Greg Bonnen, MD (R-Friendswood), and Sen. Dawn Buckingham, MD (R-Lakeway), with considerable support by Sen. Jane Nelson (R-Flower Mound). (Source: TMA News Room)
Source: TMA News Room - June 21, 2021 Category: Consumer Health News Source Type: news

Blue Cross NC joins group sounding alarm, demanding action over state's mental health crisis
A coalition of organizations, including the state's largest insurer, is demanding that lawmakers dedicate more resources to improving the quality of and access to mental health care in North Carolina. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - June 21, 2021 Category: Biotechnology Authors: Sonia Waraich Source Type: news

Insurers Delay Bariatric Surgery for'Reprehensible' Reason Insurers Delay Bariatric Surgery for'Reprehensible' Reason
Some US health insurers are restricting access to bariatric surgery to patients with a BMI (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - June 18, 2021 Category: Consumer Health News Tags: Diabetes & Endocrinology News Source Type: news

Blue Cross NC among group sounding alarm, demanding action over state's mental health crisis
A coalition of organizations, including the state's largest insurer, is demanding that state lawmakers dedicate more resources to improving the quality of and access to mental health care in North Carolina. (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - June 18, 2021 Category: American Health Authors: Sonia Waraich Source Type: news

United Wants to Charge You for ER Visits It Disagrees With United Wants to Charge You for ER Visits It Disagrees With
The nation's largest health insurer says it still plans to stop paying for ER visits it decides are unnecessary.WebMD Health News (Source: Medscape Emergency Medicine Headlines)
Source: Medscape Emergency Medicine Headlines - June 18, 2021 Category: Emergency Medicine Tags: Emergency Medicine News Source Type: news

Kenya: NHIF Must Pay Meridian Sh130m, High Court Rules
[Nation] Health insurer NHIF has been ordered to pay Meridian Medical Centre Sh130 million that it failed to pay after terminating an outpatient service contract nine years ago. (Source: AllAfrica News: Health and Medicine)
Source: AllAfrica News: Health and Medicine - June 17, 2021 Category: African Health Source Type: news

Bariatric Surgery Works, But Isn't Offered To Most Teens Who Have Severe Obesity
Experts now say the procedure is the most effective treatment for severe childhood obesity, which affects a growing number of kids. But stigma and insurers often stand in the way.(Image credit: Kayla Northam ) (Source: NPR Health and Science)
Source: NPR Health and Science - June 17, 2021 Category: Consumer Health News Authors: Yuki Noguchi Source Type: news

Drug rebates for insurers tied to higher costs for patients, especially the uninsured
(University of Washington) The study found that rebates were associated with increases in out-of-pocket costs for patients by an average of $6 for those with commercial insurance, $13 for Medicare patients and $39 for the uninsured. (Source: EurekAlert! - Medicine and Health)
Source: EurekAlert! - Medicine and Health - June 15, 2021 Category: International Medicine & Public Health Source Type: news

Maryland health insurers request price increase for 2022 plans, breaking a three-year streak
The rates will undergo a review, including sourcing of public comments, and be announced no later than Sept. 7. A virtual public hearing on the rates will be held July 20. (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - June 14, 2021 Category: American Health Authors: Carley Milligan Source Type: news

Kenya: Kemri Employees Exposed as Insurer Suspends Medical Cover
[Nation] For four months, over 1,000 employees of the Kenya Medical Research Institute and their 4,000 dependants have not had access to a medical cover despite being frontline workers due to failure by management to clear arrears with the insurer. (Source: AllAfrica News: Health and Medicine)
Source: AllAfrica News: Health and Medicine - June 14, 2021 Category: African Health Source Type: news

Auto insurance rates rise, but insurers could still qet squeezed by higher costs ahead
Auto insurers refunded $14 billion in premiums last year, according to the Insurance Information Institute. Rates have since stagnated... (Source: Reuters: Health)
Source: Reuters: Health - June 12, 2021 Category: Consumer Health News Source Type: news

Oscar Health's CEO on how insurance companies have transformed during COVID-19
At HIMSS'State of Healthcare event on June 15, Oscar CEO Mario  Schlosser will discuss how the insurance space has adjusted to the COVID-19 demands.  (Source: mobihealthnews)
Source: mobihealthnews - June 11, 2021 Category: Information Technology Tags: < div class= entity entity-paragraphs-item paragraphs-item-enterprise-taxonomy about= typeof= > content /div Source Type: news

The Controversy Over the FDA ’s Approval of The First Alzheimer’s Treatment Keeps Growing
“The whole thing is befuddling, and a series of inexplicable surprises,” says Dr. Caleb Alexander, professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health. Alexander is a member of the U.S. Food and Drug Administration’s advisory committee that provided recommendations to the agency on whether or not to approve the Alzheimer’s drug aducanumab. On June 7, the FDA did approve the drug (under the brand name Aduhelm), in a highly controversial decision that continues to divide the Alzheimer’s community. Patients and advocacy groups, including the Alzheimer&rsq...
Source: TIME: Health - June 11, 2021 Category: Consumer Health News Authors: Alice Park Tags: Uncategorized Source Type: news

UnitedHealthcare May Deny Emergency Visit Coverage
Within days of announcing a policy shift aimed at cutting back on reimbursements for emergency room care, the major insurer retreated — for now. (Source: NYT Health)
Source: NYT Health - June 11, 2021 Category: Consumer Health News Authors: Reed Abelson Tags: Emergency Medical Treatment Health Insurance and Managed Care Hospitals Coronavirus (2019-nCoV) American College of Emergency Physicians American Hospital Assn American Medical Assn UnitedHealth Group Inc your-feed-healthcare Source Type: news

Government Warns Doctors and Insurers: Don ’t Bill for Covid Vaccines
Such billing has been rare, but public concern about it may be contributing to hesitancy about getting the shot. (Source: NYT)
Source: NYT - June 9, 2021 Category: American Health Authors: Sarah Kliff Tags: Vaccination and Immunization Coronavirus (2019-nCoV) Prices (Fares, Fees and Rates) Health Insurance and Managed Care Source Type: news

EXPLAINER: How will insurers cover a new Alzheimer's drug?
Federal regulators have approved the first new drug for Alzheimer’s disease in nearly 20 years, leaving patients waiting to see how insurers will handle the pricey new treatment (Source: ABC News: Health)
Source: ABC News: Health - June 8, 2021 Category: Consumer Health News Tags: Health Source Type: news

The First Treatment for Alzheimer ’s Disease Is Here
Alzheimer’s disease was first described by Alois Alzheimer in 1906, and now, more than 100 years later, doctors have an effective drug to treat the cognitive disorder. On June 7, the U.S. Food and Drug Administration (FDA) approved aducanumab, developed by the U.S.-based biotech Biogen and Japanese pharmaceutical company Eisai. But the drug’s approval comes with a caveat. The FDA is requiring Biogen to conduct an additional placebo controlled study of the drug to verify it’s effectiveness in improving people’s memory and cognitive symptoms. That request stems in large part from the conclusion of an ...
Source: TIME: Health - June 7, 2021 Category: Consumer Health News Authors: Alice Park Tags: Uncategorized Source Type: news

Pittsburgh-based workers comp insurer expands into Maryland
Workpartners, which has grown to be the eighth-largest workers ’ comp provider in Pennsylvania, is expanding its reach. (Source: bizjournals.com Health Care News Headlines)
Source: bizjournals.com Health Care News Headlines - June 4, 2021 Category: Health Management Authors: Paul J. Gough Source Type: news

Pittsburgh-based insurer expands into new states
Workpartners is a division of UPMC Insurance Services, the $10 billion in revenue insurance division that includes UPMC Health Plan. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - June 4, 2021 Category: Pharmaceuticals Authors: Paul J. Gough Source Type: news

Prixa scores $3M to scale AI health management platform
The health startup provides telemedicine services for insurance companies, corporations and government entities. (Source: mobihealthnews)
Source: mobihealthnews - June 4, 2021 Category: Information Technology Source Type: news

Startup fighting delayed diagnosis in breast cancer snags $1M investment
Portland women ’s health care startup Gabbi Inc raised $1 million from investors earlier this year with plans to not only hire but to capitalize on a pipeline of pilot programs with insurers and raise a full seed round in the next three to nine months. The company is building a product to help women better und erstand their risks of breast cancer and then formulate action plans that can be taken to their health care provider. It also builds a network of women in the same risk population so they… (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - June 2, 2021 Category: Biotechnology Authors: Malia Spencer Source Type: news

Making Sense of LAMA Discharges Making Sense of LAMA Discharges
There is no evidence that insurance companies will not pay for LAMA discharges.Medscape Medical News (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - June 1, 2021 Category: Consumer Health News Tags: Family Medicine/Primary Care News Source Type: news

WNY commercial insurers submit rate requests for next year
Statewide, health insurers have requested average increases of 11.2% for individuals and 14% for small groups. But the increases must be approved by the state Department of Financial Services. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - June 1, 2021 Category: Pharmaceuticals Authors: Tracey Drury Source Type: news

Key rule change for Blue Cross could mean lower costs for NC consumers
The Blue Cross Blue Shield Association has eliminated a rule in a move that is expected to mean more competition for North Carolina's largest insurer and potentially lower premiums for consumers. (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - June 1, 2021 Category: American Health Authors: Sonia Waraich Source Type: news

Delta Dental launches nationwide effort to advance patient-centered care
Delta Dental will administer the CAHPS Dental Plan Survey nationally to gather insights into patients'oral health experiences and improve oral healthcareOAK BROOK, Ill., May 19, 2021 /PRNewswire/ -- Today, Delta Dental Plans Association announced the nationwide deployment of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Dental Plan Survey by its member companies covering all 50 states, D.C., and Puerto Rico in 2021. " Our mission is to advance the oral health of all Americans, and we are proud that we will be the first commercial health insurer to deploy the CAHPS Dental Plan Survey nat...
Source: Dental Technology Blog - May 28, 2021 Category: Dentistry Source Type: news

Applying private insurer rules to Medicare Part B
(JAMA Network)What The Study Did:Researchers estimated the extent Medicare Part B medical services would have been subject to prior authorization under private insurance coverage policies and calculated the associated spending. (Source: EurekAlert! - Social and Behavioral Science)
Source: EurekAlert! - Social and Behavioral Science - May 28, 2021 Category: International Medicine & Public Health Source Type: news

APA Moves to Stop Insurer Overturning Mental Health Claims Ruling APA Moves to Stop Insurer Overturning Mental Health Claims Ruling
The APA and other medical groups agree that the insurer improperly denied thousands of mental health and substance use claims.Medscape Medical News (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - May 26, 2021 Category: Consumer Health News Tags: Psychiatry News Source Type: news

Jefferson not planning to compete with commercial insurers as it preps for control of Health Partners Plans
Jefferson expects to secure 100% ownership of Philadelphia Medicaid and Medicare HMO Health Partners Plans by mid-November. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - May 25, 2021 Category: Biotechnology Authors: John George Source Type: news

Bill Seeks to Streamline Prior Authorization in MA Plans Bill Seeks to Streamline Prior Authorization in MA Plans
A House bill would compel insurers to streamline processes for prior authorization decisions for Medicare Advantage plans, seeking a shift to systems that would operate in real time and not use faxes.Medscape Medical News (Source: Medscape General Surgery Headlines)
Source: Medscape General Surgery Headlines - May 25, 2021 Category: Surgery Tags: Family Medicine/Primary Care News Source Type: news

Covid Killed His Father. Then Came $1 Million in Medical Bills.
Insurers and Congress wrote rules to protect coronavirus patients, but the bills came anyway, leaving some mired in debt. (Source: NYT)
Source: NYT - May 21, 2021 Category: American Health Authors: Sarah Kliff Tags: Coronavirus (2019-nCoV) Health Insurance and Managed Care Prices (Fares, Fees and Rates) Coronavirus Aid, Relief, and Economic Security Act (2020) United States Source Type: news

One year later | Stephanie Browne: 'I've been here before'
Stephanie Browne has spent the last five years as the vice president of talent acquisition and the chief diversity and inclusion officer at Blue Cross Blue Shield of Massachusetts, capping a 26-year career at the health insurer. At 63, she says she's seen her fair share of uprisings — but last summer's protests in the wake of George Floyd's death are unlike any movement since the 1960s. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - May 21, 2021 Category: Pharmaceuticals Authors: Rowan Walrath Source Type: news

First They Fought the Virus. Now They Battle the Medical Bills.
Insurers and Congress wrote rules to protect coronavirus patients, but the bills came anyway, leaving some mired in debt. (Source: NYT)
Source: NYT - May 21, 2021 Category: American Health Authors: Sarah Kliff Tags: Coronavirus (2019-nCoV) Health Insurance and Managed Care Prices (Fares, Fees and Rates) Coronavirus Aid, Relief, and Economic Security Act (2020) United States Source Type: news

Overjet's Dental Assist Receives FDA Clearance to Bring AI to the Dental Practice
In a Dental Industry First, Overjet's Dental Assist Receives FDA Clearance to Bring AI to the Dental PracticeNEWS PROVIDED BYOverjet May 20, 2021, 09:00 ETBOSTON, May 20, 2021 /PRNewswire/ -- Overjet, the global leader in dental artificial intelligence, today announced that it received FDA 510(k) clearance for its Overjet Dental AssistTM product. This Software as a Medical Device product applies artificial intelligence in real-time to aid dentists and hygienists. The clearance by the FDA will enable Overjet to market and sell the AI product directly to dental practices. The software supports dental...
Source: Dental Technology Blog - May 20, 2021 Category: Dentistry Source Type: news

Health insurance premiums could rise modestly in Oregon in 2022
Insurers are asking for increases in the low single digits. (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - May 19, 2021 Category: American Health Authors: Elizabeth Hayes Source Type: news

Health insurance premiums could rise modestly in Oregon in 2022
Insurers are asking for increases in the low single digits. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - May 19, 2021 Category: Biotechnology Authors: Elizabeth Hayes Source Type: news

Bright Health files for initial public offering
The Minneapolis-based health insurance company intends to offer its stock on the New York Stock Exchange under the ticker "BHG." (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - May 19, 2021 Category: American Health Authors: Carrigan Miller Source Type: news

Bright Health files for initial public offering
The Minneapolis-based health insurance company intends to offer its stock on the New York Stock Exchange under the ticker "BHG." (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - May 19, 2021 Category: Biotechnology Authors: Carrigan Miller Source Type: news

State's largest insurer loses 80K members as Covid effects linger
The state ’s largest health insurer lost nearly 80,000 members as unemployment soared through the pandemic, one of several lingering Covid effects insurers are facing even as the rest of the state returns to normalcy. (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - May 18, 2021 Category: Pharmaceuticals Authors: Jessica Bartlett Source Type: news

Ransomware hits AXA units in Asia, Irish healthcare
The Thai affiliate of Paris-based insurance company AXA says it is investigating a ransomware attack by Russian-speaking cybercriminals that has affected operations in Thailand, Malaysia, Hong Kong and the Philippines (Source: ABC News: Health)
Source: ABC News: Health - May 18, 2021 Category: Consumer Health News Tags: Health Source Type: news

Ransomware hits AXA units in Asia, hurts Ireland healthcare
Russian-speaking cybercriminals have hit subsidiaries of the Paris-based insurer AXA in Thailand, Malaysia, Hong Kong and the Philippines with a ransomware attack (Source: ABC News: Health)
Source: ABC News: Health - May 18, 2021 Category: Consumer Health News Tags: Health Source Type: news

Atrium Health creates another executive role for managed care
Atrium Health has made more adjustments within its executive team. The health-care system named Michael Parkerson as its chief managed health executive, a newly created position. The new role is focused on Atrium's relationships with insurance companies, health plans and government programs. The goal is to better integrate patient needs into the negotiations for more comprehensive care results, Parkerson said. He said this is a more progressive model in the health-care ind ustry. "It's a pretty… (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - May 13, 2021 Category: American Health Authors: Caroline Hudson Source Type: news

Privacy fears around patients' health data breach amid Covid surge
For example, a Covid patient's blood reports, health history, plasma infusion details are now available on the dark web. They can be accessed by banks and insurance companies who can then take a call if the patient should be offered a loan, or find out what is his credit history, or if he later goes for an insurance, what should be his premium. (Source: The Economic Times)
Source: The Economic Times - May 13, 2021 Category: Consumer Health News Source Type: news

Covid-19 patients' health data being sold on dark web
For example, a Covid patient's blood reports, health history, plasma infusion details are now available on the dark web. They can be accessed by banks and insurance companies who can then take a call if the patient should be offered a loan, or find out what is his credit history, or if he later goes for an insurance, what should be his premium. (Source: The Economic Times Healthcare and Biotech News)
Source: The Economic Times Healthcare and Biotech News - May 13, 2021 Category: Pharmaceuticals Source Type: news

Nemours embarks on strategic plan to 'redefine children's health,' will rename Wilmington hospital
Nemours also wants to work with health insurers to change the payment model to one that encourages health systems to keep patients from needing to seek care in a hospital. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - May 12, 2021 Category: Biotechnology Authors: John George Source Type: news

Even small bills for health insurance may cause healthy low-income people to drop coverage
(Michigan Medicine - University of Michigan) Twenty dollars a month might not seem like a lot to pay for health insurance. But for people getting by on $15,000 a year, it's enough to make some drop their coverage - especially if they're healthy, a new study of Medicaid expansion participants in Michigan finds. That could keep them from getting preventive or timely care, and could leave their insurance company with a sicker pool of patients than before. (Source: EurekAlert! - Medicine and Health)
Source: EurekAlert! - Medicine and Health - May 10, 2021 Category: International Medicine & Public Health Source Type: news

Pfizer-BioNTech Has Requested Full Approval of Their COVID-19 Vaccine From the FDA
Pfizer-BioNTech announced on May 7 that they have requested that the U.S. Food and Drug Administration (FDA) start the process of fully approving their COVID-19 vaccine. The companies will continue to supply the agency with additional data on vaccination safety and effectiveness on a rolling basis over coming weeks. The FDA issued an emergency use authorization for the shot in December, based on short-term data on safety and efficacy. Now, the companies have the required six-month data on the vaccine to support a biologics license application, which the FDA will review over the next several weeks before making a decision. ...
Source: TIME: Health - May 7, 2021 Category: Consumer Health News Authors: Alice Park Tags: Uncategorized COVID-19 Source Type: news

Kenya: Tenwek Hospital Suspends Medical Services to Teachers Over Sh45 Million Bill
[Nation] Tenwek Hospital has suspended medical services to teachers covered by AON Minet insurance company over Sh45 million bill. (Source: AllAfrica News: Health and Medicine)
Source: AllAfrica News: Health and Medicine - May 7, 2021 Category: African Health Source Type: news

Hit by Higher Prices for Gear, Doctors Want Insurers to Pay Hit by Higher Prices for Gear, Doctors Want Insurers to Pay
The costs of personal protective equipment and disinfecting offices while seeing fewer patients have some doctors and dentists demanding that insurance companies step up.Kaiser Health News (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - May 5, 2021 Category: Consumer Health News Tags: Internal Medicine News Source Type: news

New Federal Program Reimburses Vaccine Administration Fees New Federal Program Reimburses Vaccine Administration Fees
Doctors who have vaccination administration claims denied by certain private insurers can apply to the government's Health Resources and Services Administration for reimbursement.Medscape Medical News (Source: Medscape Infectious Diseases Headlines)
Source: Medscape Infectious Diseases Headlines - May 5, 2021 Category: Infectious Diseases Tags: Internal Medicine News Source Type: news

Study finds most patients feel the pinch when drug prices go up
Drug companies have long argued that increases in list prices don't significantly affect patients, because insurance companies pay the bulk of the cost, and rebates from drug companies to insurers largely offset out-of-pocket costs. But a study published Tuesday suggests that more than half of all patients do in fact pay more when overall costs go up. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - May 5, 2021 Category: Biotechnology Authors: Jessica Bartlett Source Type: news