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Health Groups Have High Hopes for the Latest Prior Authorization Bill

"We believe the bill is poised for adoption this year," said one expert

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Medicare Pay, Prior Auth, and More: A Q&A With the AMA's President-Elect

Bobby Mukkamala, MD, also says he wants to improve medical record interoperability

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Fix What's Broken in Healthcare Is New AMA President's Priority

That includes raising Medicare reimbursement and lessening prior authorization, says Bruce Scott

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Increase $$ for Physicians, Institute Site-Neutral Payment, MedPAC Report Suggests

Inadequate payments could force some docs to stop accepting Medicare patients, commission warns

A screenshot of Representative Rep. Morgan Griffith speaking during this hearing.

House Committee Divided on Whether Changes are Needed in 340B Drug Discount Program

Program's value undisputed, but some members say hospitals are taking unfair advantage

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What if Medicaid Enrollees Were Given Cash Instead of Insurance Benefits?

Having them buy insurance or pay for services directly would bring down prices, supporters say

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MGMA: Docs 'Defy Gravity' of Inflation, Staff Shortages by Working Harder

Report shows which of 23 specialty groups and primary care practices earned more in 2023

A screenshot of Timothy Richardson, MD, speaking during this hearing.

More Money, Fewer Prior Auths Needed to Save Private Practices, Lawmakers Told

Medicare rates' failure to keep up with inflation is especially damaging, doctors say

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Senate Paper Mulls Options for Fixing Physician Pay in Fee-for-Service Medicare

Regular inflation updates, getting rid of MIPS among the ideas discussed

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Revisiting 'Left Without Being Seen' Metrics in the ED

The current system drives problematic decisions regarding how care is allocated

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I'm a Former Surgeon General and I Couldn't Believe My $10k Medical Bill

Everyone must be able to access necessary care without fear of financial ruin

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Fraudulent Practices Abound in Post-Accident Healthcare

These costs often fall unfairly on patients and insurance providers

A screenshot of Sheldon Whitehouse speaking during this hearing.

Pre-Approval Plan Proposed for Medicare Advantage Insurers

"No prior authorization without prior authorization," Senate Budget Committee chair says

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Medicare Hospital Trust Fund to Stay Solvent Until 2036, Trustees' Report Says

Projection is 5 years longer than last year's prediction

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Fed Up With Prior Auths? What if Insurers Had to Pay You for Submitting Them?

NYC urologist is seeking approval for a prior authorization CPT code

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The Plight of the Late-Boomer Physician

Does anyone besides me feel like we got the short end of the financial stick?

A screenshot of UnitedHealth CEO Andrew Witty speaking during this hearing.

UnitedHealth CEO Slammed at Senate Hearing on Change Healthcare Cyberattack

"A comprehensive scrub" of company's anti-competitive practices is long overdue, senator says

A screenshot of Daniel Tsai speaking during this hearing.

House Republicans Bash New Nursing Home and Home Care Rules at Hearing

"This approach simply won't work," said chair of the House Energy & Commerce Health Subcommittee

A photo of Adam Bruggeman, MD speaking during this hearing.

Lawmakers Take Up Fallout From Change Healthcare Cyberattack

Health sector likely to remain an "attractive target," says congressman

A screenshot of Frank Pallone speaking during this hearing.

Improper Payments in Medicare and Medicaid: Who's at Fault?

Republicans and Democrats took differing approaches on the subject at a House hearing

Federal Probes Need to Look Beyond Private Equity-Owned Healthcare for Alleged Abuse

Non-profit entities should also be fair game, says Ron Harman King, JD, MS

A screenshot of Lee Schwamm, MD, speaking during this hearing.

House Members Struggle to Craft Road Map for Future of Telehealth

Lawmakers examine issues around reimbursement, licensure, and patient choice

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Biden Administration Cracks Down on 'Junk' Health Insurance Plans

Under final rule, insurers will have to spell out what these policies do not include

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Medicare Debuts Another Primary Care-Focused Accountable Care Model

Primary Care Flex will pay ACOs a monthly fee to be given to primary care practices

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Medicare to Cover Weight-Loss Drug Wegovy for Certain Patients

News comes in the wake of FDA approval to reduce risk of heart attacks, stroke

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California Wants to Pay Doctors More Money to See Medicaid Patients

How much and who will get it will be determined later this year

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MedPAC's Report Recommends Pay Changes for Healthcare Services

Report highlights MA quality, overpayment issues, and urges action on four prior recommendations

How Can the U.S. Prevent Future Cyberattacks Like the One on Change Healthcare?

To start with, more "outside in" testing is needed, expert says

A screenshot of Ateev Mehrotra, MD, MPH, speaking during this hearing.

Lawmakers Quibble Over Whether Telehealth Should Be Cheaper Than In-Person Visits

Lawmakers, witnesses disagree on the answer at a House hearing on home healthcare

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Largest Independent Primary Care Network in the U.S. Accused of Medicare Fraud

Whistleblower lawsuit alleges Aledade encouraged doctors to tack on suspect medical diagnoses

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MedPAC Members Pan Rural Hospitals' 'Cost-Plus' Billing System for Medicare Patients

Allowing the system to stay in place is "unconscionable," says one commissioner

A photo of Christopher Koller speaking during this hearing

Medicare a Big Contributor to the Broken Health Payment System, Senators Told

Use of "hybrid" payment model urged

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Most Doc Groups Unhappy With Proposed Congressional Budget Deal

Measure would restore some, but not all, of the cuts to the Medicare Physician Fee Schedule

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Can Artificial Intelligence Improve Prior Authorization?

Possibly, but "complete transparency" about its use would be needed, expert says

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There's Still Time to Switch Medicare Advantage Plans This Year

Beneficiaries have until March 31 to find a new plan; doctors should check plans, too

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States Target Health Insurers' Red Tape Around Prior Authorization

Pending bills in multiple states include policies backed by the AMA

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Orthopedic Surgeons on Track to Earn Less Than Taco Bell Workers

If current trends continue, patients are in big trouble

A photo of Rep. Larry Bucshon (R-Ind.) speaking at this event

Not Passing a Bill to Fix Medicare Doc Pay Cuts Is 'Appalling,' Lawmaker Says

Rep. Larry Bucshon, MD, also talks about prior authorization, violence against health workers

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MedPod Today: Medicare Advantage Woes, Double Billing, NHPI Health Disparities

番茄社区app reporters offer further insights on these recently covered topics

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Medicare Sends Initial Price Negotiation Bids to Drugmakers

Manufacturers of 10 drugs have 30 days to accept or make a counter-offer

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