Consumer Driven Health Care

The insurer did not give an explanation for the reversal of coverage for a midwife, leaving a couple with no recourse after exhausting all processes within the claims processing, including a formal appeal, which was denied.

If we don't reflect on the root cause of our drug problem, we're going to have the same hand wringing conversation five or 10 years from now, with a different set of drug names.

For the fifth consecutive year, insurer participation increased to 303 participants at the state level on the health exchanges, though some of the larger insurtech plans paused operations in select states, says a new report.

A new study, which looked at health care, food, fitness and green space in each city, reveals the places in the country where well-being is prioritized most highly—and where it could use some heavy lifting.

Many employers and insurers are opting to wait out the appeals process before considering whether to make changes to their health plans' coverage of recommended preventive services, says this ERISA litigation attorney.

At the committee level, there is a lot of bipartisan activity for health care reform for 2023 that includes PBM reforms and insulin caps in the commercial market, as well as regulatory guidance on the new retirement bill SECURE 2.0.