Health insurers issue millions of prior authorization denials every year, leaving many patients stuck in a convoluted appeals process, with little hope of meaningful policy change ahead. For doctors, these denials are frustrating and time-consuming. For patients, they can be devastating.
A new drug is helping families who’ve spent years padlocking fridges, chaining garbage cans, and hiding food as their children with Prader-Willi syndrome deal with unrelenting hunger. But additional progress — and a broader understanding of obesity — is now under threat as the government dismantles the pipeline for promising new research.
Michael Kestner, CEO of Pain MD, was convicted of 13 fraud felonies after his company gave patients hundreds of thousands of questionable injections at clinics in Tennessee, Virginia, and North Carolina.
The fatal shooting of UnitedHealthcare CEO Brian Thompson prompted both grief and public outrage about the ways insurers deny treatment. Republicans and Democrats agree prior authorization needs fixing, but patients are growing impatient.
Amid doctor shortages, several states have stopped requiring foreign-trained providers to repeat residencies before they’re fully licensed. Critics say patients could be harmed because of the loosened training requirements.
Patients and providers say health insurers’ preapproval requirements lead to delays and denials of needed medical treatments. Insurers argue that prior authorization keeps costs down.
About 3.7 million people are at immediate risk of losing health coverage should the federal government cut funding for Medicaid expansions, as some allies of President-elect Donald Trump have proposed. Coverage could be at risk in the 40 states that have expanded Medicaid.
Hundreds of people and the Federal Trade Commission weighed in on a proposed hospital merger in Terre Haute, Indiana, with most arguing that the creation of a monopoly would increase costs and worsen patient care.
Adults with disabilities and their caregivers are pressing governments and private businesses across the U.S. to help them avoid undignified public bathroom experiences.
If Indiana officials approve a proposed hospital merger in western Indiana in the coming months, the state will have its first hospital monopoly created by a “Certificate of Public Advantage.” Other such deals have resulted in government reports documenting diminished care in Tennessee and North Carolina.
