Humana has filed a lawsuit against ChenMed, which operates medical centers for older patients, in Delaware over breach of contract and other alleged harms, according to a heavily redacted Nov. 7 court filing. Humana and ChenMed jointly operate JenCare Senior…
Author: Elizabeth Casolo
Cigna Healthcare has partnered with Magic Johnson to produce “Magic Sounds,” a six-track album designed to boost mental health, according to a news release. Cigna pulled from peer-reviewed research and worked with clinical experts and music therapists to determine tempo,…
North Carson City, Nev.-based Carson Tahoe Health and the Nevada Health Authority are extending the health system’s contract with UMR, a UnitedHealthcare subsidiary, according to a Nov. 11 post. State of Nevada employees will stay in network with CTH through…
The Wasteful and Inappropriate Service Reduction initiative from CMS will take effect next year, adding prior authorization requirements to traditional Medicare. Providers in Arizona, Washington, New Jersey, Texas, Ohio and Oklahoma will pilot the new protocol. Here are eight things…
President Donald Trump proposed that federal healthcare funds bypass insurers and be directed straight to individuals in a Nov. 8 post on Truth Social. “I am recommending to Senate Republicans that the Hundreds of Billions of Dollars currently being sent…
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A Nov. 10 study found risk-based Medicare Advantage contracts had little effect on healthcare delivery. The University of Pennsylvania’s Leonard Davis Institute of Health Economics reviewed Medicare Advantage insurer data to better understand the ramifications of moving from fee-for-service to…
Mark Cuban, the billionaire entrepreneur behind Cost Plus Drugs, criticized Sen. Bernie Sanders’ Medicare for All Act Nov. 9 on X. The bill, which would establish a nationwide health insurance program, has been a longtime agenda item for Mr. Sanders,…
Six Democratic House representatives introduced legislation this month to stop the upcoming Medicare prior authorization pilot, the Wasteful and Inappropriate Service Reduction model. WISeR would implement prior authorization for some services under traditional Medicare across six states starting next year.…
Over the next several months, health plans, health systems, policymakers and patients led by Baltimore-based Johns Hopkins will begin addressing prior authorization as part of a convening group. While the group is meeting for the first time today, it will…
UnitedHealthcare will not cover remote physiologic monitoring when it is “unproven and not medically necessary,” including for Type 2 diabetes and most cases of hypertension. However, it will still cover monitoring for heart failure and hypertensive disorders of pregnancy, according…