Commercial Insurer Accountability
A Commonwealth Fund report published Aug. 1 examines how frequently insured, working-age adults are denied care by insurers; how often they are billed for services they believed were covered; and their experiences challenging such bills or care denials. The report shows that 45% of insured, working…
Congress is considering legislation that would change current billing practices for Medicare and the commercial insurance market to require each off-campus hospital outpatient department (HOPD) to be assigned a unique NPI as a condition of payment.
The AHA July 11 released its quarterly Health Care Plan Accountability Update, a roundup of news, letters, statements and other resources covering private insurance plans, Medicare Advantage and related issues.
The AHA May 2 released a new report highlighting how hospitals and health systems continue to experience significant financial pressures that challenge their ability to provide 24/7 care for patients and communities.
UnitedHealth Group’s concentration in the healthcare system is unprecedented. If it were a country, it would rank 42 in the world in Gross Domestic Product.
The American Hospital Association (AHA) writes regarding a recent The New York Times investigation into the disturbing incentives for data analytics firm, MultiPlan, and large commercial insurers like UnitedHealthcare, Aetna and Cigna, to cut reimbursement rates for care provided to employees of…
The high cost to health care providers to obtain reimbursement from insurers shows no signs of abating. A recent report from the group purchasing and consulting organization Premier highlights the long-standing problem.
Health insurers have gone through dramatic vertical consolidation since ERISA was signed into law. Over the last decade, the major corporate insurers have spent billions of dollars acquiring not only other plans, but also providers, pharmacy service companies, and health technology and claims…
People enrolled in Medicare Advantage are more likely than those in traditional Medicare to report delays in care due to needed insurance approvals, according to a survey released Feb. 22 by the Commonwealth Fund, with 13% of traditional Medicare enrollees reporting associated delays compared with…
The CMS Feb. 6 released a Frequently Asked Questions document pursuant to the calendar year 2024 Medicare Advantage final rule, which went into effect Jan. 1.