As AI has evolved to be more accurate and reliable, it's become suitable for high-stakes use cases including automating health insurance verification.
About 31% of women ages 18 to 64 with health coverage said that in the last year, they or a family member received care that their health plan did not cover at all or paid less than expected. In comparison, 26% of men said this, according to a KFF survey.
The layout of your phlebotomy station can significantly impact efficiency. A well-thought-out setup ensures that every tool is within reach, minimizing unnecessary movement and reducing patient wait times.
There are about 17 million people eligible for coverage through Medicaid or the Affordable Care Act marketplaces, and one of CMS' priorities is to make them aware of their insurance options, Administrator Chiquita Brooks-LaSure said at this year's HLTH conference.
The lawsuit alleges that an Aetna policy discriminates against LGBTQ people by requiring them to pay thousands in out-of-pocket costs for fertility treatments before becoming eligible for coverage. Though Aetna has agreed to pay the costs incurred by the plaintiffs, the suit aims to strike down the policy as a whole.
After pushing back the start date twice, CMS now wants to scrap the Trump-era rule, which provides an expedited pathway to Medicare coverage for devices that receive the FDA breakthrough designation.
The increase in access to public health insurance coverage — via legislation like the Families First Coronavirus Response Act that prevents states from disenrolling Medicaid beneficiaries — helped offset the loss of employer-sponsored insurance, the report from Robert Wood Johnson Foundation shows.
Discover what tools are essential for efficient, safe surgical extractions in today’s health care landscape, from elevators to forceps and beyond.
UnitedHealthcare and United Behavioral Health agreed to the settlement to resolve allegations that they illegally denied coverage for mental health and substance use disorder treatments. The allegations are related to business practices they no longer use, parent company UnitedHealth Group said.
CMS plans to review and determine coverage for Biogen's Aduhelm, the first new Alzheimer's disease treatment in decades. But the jury is still out on the drug's effectiveness. Not to mention, its hefty price tag — $56,000 — could drive up Medicare spending.
Per a policy update that went in to effect July 1, the health insurance giant is not covering non-emergency services that members receive at out-of-network facilities that are outside of their service area. This update mainly affects residential treatment facilities, inpatient rehabilitation and other non-hospital-based services.
Enrollment in Medicaid and the Children's Health Insurance Program has reached a record high, with 80 million now covered through these programs. The spike was largely driven by the economic downturn brought on by the pandemic and a federal requirement that prevents states from removing people from the programs until the public health crisis is over.
Employees who enjoy their benefits are more inclined to stay with their company. A 2025 Marsh McLennan Agency report said 73% of employees would remain if plan options were better.
The Supreme Court upheld the Affordable Care Act, dismissing the lawsuit brought by Texas, 17 other states and two individuals on the grounds that they were not able to prove they were harmed by the law. Industry stakeholders celebrated the court's long-awaited decision.
UnitedHealthcare is instituting a new policy beginning July 1 that changes how the payer assesses emergency department claims, allowing it to retroactively deny ones it deems "non-emergent" or not an emergency. The American College of Emergency Physicians has made its opposition clear, stating the policy may violate federal law.
Health insurers are prohibited from placing unfavorable limits on mental health and substance abuse benefits, and yet, many do. Federal and state regulators are taking aim at these practices and making the enforcement of the Mental Health Parity and Addiction Equity Act of 2008 a key focus.
A majority of the general public is in support of expanding Medicare — either by opening it up to all Americans or lowering the eligibility age, according to new survey results. But among current Medicare enrollees, nearly half want the program to stay as it is.
CMS delayed the start date of its rule that would provide expedited Medicare coverage for products the FDA deems "breakthrough devices" from May 15 to Dec. 15. CMS wants more time to examine concerns expressed about the rule, including that devices may gain coverage despite limited evidence of their use among seniors.