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How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them (ProPublica)

How Cigna Saves Millions by Having Its Doctors Reject Claims Without Reading Them by Patrick Rucker, Maya Miller and David ArmstrongMarch 25, 5 a.m. EDT Internal documents and former company executives reveal how Cigna doctors reject patients’ claims without opening their files. “We literally click and submit,” one former company doctor said. Series: Uncovered How […]

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Health Insurers Get Government Cash, Then Jack Up Prices (The Lever)

Health Insurers Get Government Cash, Then Jack Up Prices Oct 11, 2022 by David Sirota Despite the Affordable Care Act’s promises, publicly subsidized insurers are jacking up prices while Americans lose coverage. Health Insurers Get Government Cash, Then Jack Up Prices (AP Photo/Richard Drew)   Back in 2010, Democrats sold the Affordable Care Act (ACA)

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She didn’t need the risky surgery. County doctors talked her into it anyway, lawsuit says (LAT)

She didn’t need the risky surgery. County doctors talked her into it anyway, lawsuit says Bernetta Higgins at her home in Silver Lake on June 14, 2022. She says she underwent an unneeded operation at Harbor-UCLA Medical Center at the urging of a surgeon who was being paid by a medical device maker. Higgins suffered

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Shannen Doherty calls on Fran Drescher to change SAG-AFTRA healthcare rules (CoverMedia)

On Thursday, the Charmed actress took to Instagram to post a photo of her sitting in hospital with an IV in her left arm. In the accompanying caption, Shannen asked The Nanny actress, who was elected president of the labour union that represents actors and media professionals in 2021, to reconsider rules relating to health

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Humana to Exit Employer Insurance Business to Focus on Government Plans [Reuters]

Humana to Exit Employer Insurance Business to Focus on Government Plans February 23, 2023 by Sriparna Roy Editing by Savio D’Souza and Sriraj Kalluvila   Feb 23 (Reuters) – Humana Inc (HUM.N) will exit the employer-based insurance business over the next 18 to 24 months, it said on Thursday, to focus primarily on government-backed programs

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Medicare Advantage Enrollees face Higher Likelihood of Hospital Care Denials [JustCare]

Medicare Advantage Enrollees face Higher Likelihood of Hospital Care Denials February 21, 2023 by Diane Archer   Paige Minemyer reports for Fierce Healthcare that hospitals treating Medicare Advantage enrollees faced a higher likelihood of claim denials last year than the year before. Medicare Advantage plans, administered by private health insurers, use tools that limit coverage

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Medicare Advantage Plans Denied Two Million Prior Authorization Requests in 2021 [JustCare]

Medicare Advantage Plans Denied Two Million Prior Authorization Requests in 2021 February 8, 2023 by Diane Archer   Imagine that you were given a wad of cash to deliver a service when necessary. And, it was in your discretion to determine when the service was necessary. That’s effectively the way Medicare Advantage works, with the

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Life and Dollars: A Health Care Insider’s Account of how Prior Authorization Really Works [Wendell Potter]

Life and Dollars: A Health Care Insider’s Account of how Prior Authorization Really Works By: Wendell Potter (Substack) February 7, 2023   Prior authorization started out as a means by the “payers” of health care goods and services to provide patients the assurance that what their doctors order is medically necessary and appropriate. A strong

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100 Million People in America Are Saddled With Health Care Debt (KHN)

  100 Million People in America Are Saddled With Health Care Debt By Noam N. LeveyJUNE 16, 2022 DISPONIBLE EN ESPAÑOL Elizabeth Woodruff drained her retirement account and took on three jobs after she and her husband were sued for nearly $10,000 by the New York hospital where his infected leg was amputated. Ariane Buck,

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Ke Huy Quan Lost His Health Insurance Right After Filming ‘Everything Everywhere All at Once’ (Deadline)

Ke Huy Quan Lost Health Insurance After Filming ‘Everything Everywhere All At Once’ By Greg Evans March 3, 2023 1:06pm Oscar-nominated Everything Everywhere All At Once actor Ke Huy Quan is used to the long periods of inactivity in a performer’s life, but the former Goonies child star found himself in a particularly thorny stretch

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