Consumer Driven Health Care

Major insurers are taking steps to eliminate, streamline and automate some of the paperwork required for patients to get many medical tests and procedures, before the proposed CMS rule is finalized.

The ruling, which applies nationwide and takes effect immediately, mandates that insurers and employers are not required to cover certain free preventive screenings for cancer, heart disease and other diseases under Obamacare.

New analysis shows that $1.6 billion would have come from 30 non-profit hospitals – and employer groups are now urging state lawmakers to take legislative action.

Global sales of these lower-cost versions of patented and branded drugs topped $15 billion in 2020, while the market is set to double in size to more than $30 billion by 2025, according to a McKinsey report.

The bipartisan pharmacy benefit manager bill, which was approved by a Senate committee, would make it illegal to charge health plans and payers more for a prescription drug than what PBMs reimburse to the pharmacy.

Since 2019, states have been in a back-and-forth dispute with the behavioral health provider to determine whether the insurer inappropriately denied mental health and substance use disorder coverage to subscribers.