Insurers supervising the health care of Medicaid patients repeatedly reject providers’ approval of care; individuals are more likely to develop dementia if they live in disadvantaged neighborhoods; a type of an immunity gene is found in people who test positive for COVID-19 but don’t develop symptoms.
Private health insurance companies contracted by Medicaid rejected millions of requests for care for low-income Americans with minimal oversight from federal and state authorities, according to a new report, according to The New York Times. The report released by the HHS inspector general’s office described how often private insurance plans denied treatment approval bids and how states handled these rebuts. Doctors claim that requirements of prior authorization usually just interfere with needed services. The report highlighted the vital role officials should play in making sure the denials are justified.
A study published in JAMA Neurology finds that Americans who reside in neighborhoods with less socioeconomic advantage might be at increased risk of dementia, reported STAT News. This can be the case no matter the individual’s background, with the study finding that people living in areas of the country with the lowest rates of income, education, employment, and housing quality possessed a 1.17 times higher risk of developing dementia compared with those living in the most prosperous areas.
Scientists have discovered a type of a specific gene that might explain why some people who test positive for COVID-19 never develop symptoms, according to The Washington Post. This finding could assist scientists with creating new vaccines and treatments. Studies have discovered that at least 20% of people who contract COVID-19 are asymptomatic, on average. Scientists think that these people might have more rapid immune responses to fight the virus before symptoms are established and lead to health issues.
The Joint Commission is launching the Rural Health Clinic Accreditation Program to standardize staff training and patient care practices at rural health clinics nationwide; the American Cancer Society recently launched the largest-ever study of cancer risk and outcomes in Black women; the HHS COVID-19 vaccination campaign saved $732 billion by preventing illness and related costs.
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CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection
May 7th 2024On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega, about the recent CMS final rule on Medicare Part D and Medicare Advantage.
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Tackling Health Inequality: The Power of Education and Experience
April 30th 2024To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.
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Access Denied: CMS’ Action Hurts Patients With Cancer in Rural America
May 6th 2024CMS rules hindered the access of rural patients with cancer to medically integrated pharmacies in 2023. The authors discuss the impact on equity in health care, emphasizing the need for regulatory change.
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What Mass General Brigham Is Doing to Combat Prostate Cancer Disparities Among Men of Color
May 5th 2024Quoc-Dien Trinh, MD, MBA, chief of urology at Brigham & Women's Faulkner Hospital, highlighted successful efforts to improve prostate cancer care access for underserved communities in Massachusetts.
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