Susan Morse
The insurer was set to limit reimbursement, starting Jan. 1, 2026, for remote physiologic services to heart failure and hypertensive disorders of pregnancy.
Proposed rule increases requirements for price comparison tools by aligning them with consumer protections established under the No Surprises Act.
Reviewers looked at how the company manages patient care and, reportedly, prior authorization requests by healthcare providers.
Vote on an extension is expected next month after four Republicans went against GOP leadership.
The longer duration, along with improved benchmarks and risk adjustment, is expected to attract a broader range of ACOs.
In the best case scenario, hospitals “are getting 20% less than the lowest workman’s comp fee schedule in the country,” says Zachary Schultz of EnableComp.
A relatively new form of H3N2 identified this year called Clade K has resulted in increased cases, says Andy Pekosz of the Johns Hopkins Bloomberg School of Public Health.
All community and independent pharmacies in the Optum Rx network are transitioning to cost-based contracts.
On Jan. 1, impacted payers will have limited time to respond to prior authorization requests, as mandated in the Interoperability and Prior Authorization final rule.
Among a number of moves at Humana, former Amazon VP of Healthcare Aaron Martin will become president of Medicare Advantage.