Whistleblower’s Claims About Medicare Advantage
A former official at UnitedHealth is asserting that big insurance companies are gaming Medicare Advantage, and have been doing so for years. The New York Times reported that a whistleblower described how companies gamed the system to make patients look sicker than they were in order to get more money from Medicare Advantage. The Department of Justice is taking the claims seriously and has said it intends to sue UnitedHealth Group and investigate other participants in Medicare Advantage.
Small Businesses Can Bypass HealthCare.gov
A new Trump administration rule change will allow small businesses to sign up for insurance through an agent or broker instead of HealthCare.gov. Currently, there are 85,000 people covered through the Small Business Health Options Program, which is far less than the millions expected when the program launched, reported The Hill. The rule change will take effect January 1, 2018, and businesses will still have to use HealthCare.gov to determine eligibility.
California Considers Protecting Family Planning Services
A new bill in California would allow patients to get care from the provider they are most comfortable with. According to California Healthline, the bill is being used to keep the federal rule that allows Medicaid patients to see the family planning provider they want, thus protecting access to Planned Parenthood and similar health clinics. The bill, which cleared the Senate Health Committee and now goes to the Senate Appropriations Committee, protects access even as the American Health Care Act that passed the US House of Representatives cuts federal funding for Planned Parenthood.
Standard Criteria for Loss of Ambulation Needed in DMD
April 19th 2024A recent study suggests the differences between ambulation definitions for patients with Duchenne muscular dystrophy (DMD) can impact the identification of ambulant vs nonambulant individuals, and standard criteria across settings are needed.
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Navigating Health Literacy, Social Determinants, and Discrimination in National Health Plans
February 13th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the February 2024 issue of The American Journal of Managed Care® about their findings on how health plans can screen for health literacy, social determinants of health, and perceived health care discrimination.
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An Overview of Health Care and Pharmaceutical Trends, 2023-2024
April 19th 2024Douglas M. Long, BA, MBA, was featured as the keynote speaker on the closing day of The Academy of Managed Care Pharmacy 2024 annual meeting, with a session dedicated to surveying the health care and pharmaceutical trends of the last year.
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Drs Raymond Thertulien, Joseph Mikhael on Racial Disparities in Multiple Myeloma Care Access
December 28th 2023In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.
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Real-World Study Reveals Key Insights Into DLBCL Treatment Patterns, Outcomes
April 18th 2024A recent study offers valuable insights into the characteristics, treatment patterns, and outcomes of diffuse large B-cell lymphoma (DLBCL) in patients across different lines of therapy, providing a look into the landscape of DLBCL management.
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