STAT

OCTOBER 11, 2022

Bright Health Group is drastically cutting back its health insurance offerings for next year, including a full exit of the individual Affordable Care Act marketplaces, and is attempting to raise $175 million to keep the company afloat. Just last month, Bright hosted health insurance brokers on a yacht ahead of the open enrollment season.

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Insurance Documentation 98

STAT

NOVEMBER 20, 2023

Financial documents at a prominent hospital system in Los Angeles show just how large those discounts are — and how raw of a deal uninsured patients could be getting. 30, according to new financial documents. Hospitals’ list prices for surgeries, therapies, and other procedures always come with massive discounts.

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Hospitals Documentation Insurance 138

The Checkup by Singlecare

JUNE 28, 2024

Although some healthcare providers prescribe Ozempic off-label for weight loss, insurance often won’t cover Ozempic for these uses unless it’s medically justified and no alternative treatments exist. We’ll explain when insurance covers Ozempic and how to advocate for coverage. When does insurance cover Ozempic for weight loss?

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Insurance Insurance Coverage Labelling Medical Records 96

STAT

NOVEMBER 2, 2023

Mothers, children, and the disabled clutch passels of documents along the sidewalk. They wait to reauthorize their Medicaid insurance. We would all be healthier if we brought the two lines together. The first line forms every morning before the building opens. Read the rest…

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Documentation Insurance Hospitals 121

STAT

MARCH 26, 2024

Troubled hospital operator Steward Health Care, grappling with a financial crisis that’s engulfed its eight Massachusetts hospitals, has moved to shore up its finances by striking a deal to sell its nationwide physician network to insurance giant UnitedHealth’s Optum Care unit. Continue to STAT+ to read the full story…

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Hospitals Documentation Insurance 145

STAT

NOVEMBER 14, 2023

The nation’s largest health insurance company pressured its medical staff to cut off payments for seriously ill patients in lockstep with a computer algorithm’s calculations, denying rehabilitation care for older and disabled Americans as profits soared, a STAT investigation has found.

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Health Insurance Companies Insurance Documentation 145

STAT

NOVEMBER 14, 2023

For more than a year, our reporters have documented how the use of artificial intelligence is driving denial of claims or delaying treatment for seriously ill patients. This latest story goes even deeper, establishing how the denial of claims was by design.

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Health Insurance Companies Documentation Insurance 130

STAT

FEBRUARY 27, 2024

antitrust regulators into pharmaceutical industry middlemen has been stymied because the companies have failed to provide many of the documents that, in some cases, were requested as far back as June 2022. A much-anticipated inquiry by U.S.

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Documentation Insurance 145

STAT

JANUARY 30, 2023

The federal government and health insurance companies have been clashing for more than a decade over how Medicare Advantage plans should be audited and how the well-documented overpayments to those plans should be clawed back.

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Health Insurance Companies Insurance Documentation 119

STAT

MAY 17, 2023

Senators warned the country’s largest Medicare Advantage insurers at a hearing on Wednesday that they must abide by Medicare’s coverage rules and cannot rely on algorithms to deny care that patients need. Congress is ramping up its oversight, too.

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Insurance Documentation 116

STAT

JULY 10, 2024

This document is where the government has in the past rolled out changes to the so-called hospital price transparency rule, but the Biden administration did not address the issue in this edition. Since 2021, hospitals have been required to post the prices they have negotiated with all health insurance companies, as well as their cash prices.

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Hospitals Health Insurance Companies Documentation Insurance 133

STAT

OCTOBER 16, 2024

But inside a UnitedHealth practice, the “#1 PRIORITY” became documenting older patients’ chronic illnesses to generate more revenue from the federal government, the emails show. . At the time, deaths from Covid-19 were surging, and no vaccine was available.

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Documentation Vaccines Insurance 145

STAT

FEBRUARY 23, 2023

attorney general is specifically looking at “communications with AKF, documents relating to donations to the AKF, and communications with patients, providers, and insurers regarding the AKF.” DaVita disclosed the new “civil investigative demand” in its latest annual financial filing to investors.

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Communication Insurance Documentation 98

The Checkup by Singlecare

JUNE 9, 2024

Although Tresiba may be covered by insurance, people without health insurance may bear the full retail cost of the medication. Is Tresiba covered by insurance? Most commercial insurance plans cover Tresiba. How much does Tresiba cost without insurance? A 10 mL vial may cost around $450 without insurance.

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Insurance Insurance Coverage Dosage Independent Pharmacies 72

STAT

DECEMBER 29, 2022

The downfall of Aduhelm, the first new treatment for Alzheimer’s disease in two decades, is largely the story of a drug company choosing to maximize its potential profits at the expense of patients and taxpayers, according to a congressional investigation that cites thousands of pages of internal Biogen documents.

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Insurance Documentation FDA 98

STAT

OCTOBER 23, 2023

Starting in the first quarter of 2024, Optum’s post-acute-care companies will be called Home & Community Care, according to internal documents obtained by STAT. However, Optum advised employees that “Home & Community Care should not be directly next to the Optum logo” in marketing materials.

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Documentation Patient Care Hospitals Insurance 145

STAT

MAY 17, 2023

By seeking documents from Zinc Health Services and Ascent Health Services, the agency is attempting to unravel what critics complain is an opaque set of business practices and relationships. Pharmacy benefit managers are linchpins in the pharmaceutical pricing system, and are under increased scrutiny for allegedly driving up consumer costs.

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Documentation Insurance 103

STAT

MARCH 18, 2024

CVS Caremark, the PBM owned by CVS Health that oversees the prescription drug benefits of 103 million people, told its employer clients that it anticipated “more lower-cost products (including specialty biosimilars) may become preferred products” on its lists of approved drugs for 2024, according to documents obtained by STAT.

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Documentation Pharmaceutical Companies Pharmaceutical Companies Insurance 145

STAT

JANUARY 8, 2024

In a country with a well-documented obesity epidemic, Wegovy and other members of a new type of weight-loss drug are highly effective: In clinical trials, people on Wegovy typically lose 15% of body weight , and a similar medication, retatrutide, has shown up to 24% weight loss.

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Documentation Insurance 125

STAT

DECEMBER 6, 2023

million worth of stock on Tuesday, according to the documents filed with the Securities and Exchange Commission. Stephen Hemsley, the board chair and former CEO of UnitedHealth Group, has sold nearly $113 million worth of company stock since the middle of October, new filings show. Hemsley most recently sold $36.4 The other $76.5

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Documentation Insurance 130

STAT

NOVEMBER 14, 2023

Internal documents revealed that managers within the company set a goal for clinical employees to keep patients rehab stays within 1% of the days projected by the algorithm. The lawsuit filed in the U.S.

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Nursing Homes Documentation Insurance 145

STAT

JUNE 8, 2023

… The pharmaceutical industry has spent the past year speaking out against new mechanisms that could limit how much governments or insurers pay for certain new medicines, but U.S. Wall Street analysts wrote investors that the documents seemed to suggest the agency will approve the drug. Have a smashing time.

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FDA Documentation Insurance 98

Pharmaceutical Technology

JULY 15, 2022

The documents state that a partnership with a CMO would be cheaper than the state directly manufacturing insulin. In April, the US House of Representatives passed the Affordable Insulin Act, which set a price cap of $35 a month for Medicare and private insurance users.

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Insurance Documentation Packaging 131

STAT

FEBRUARY 28, 2024

antitrust regulators into pharmaceutical industry middlemen has been stymied because the companies have failed to provide many of the documents that, in some cases, were requested as far back as June 2022 , STAT writes. The … A much-anticipated inquiry by U.S.

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FDA Documentation Insurance 127

The Checkup by Singlecare

MARCH 10, 2025

But there are several reliable ways to save, even if you dont have insurance. Without help from an insurance company or any other sources, the average retail price of Januvia is around $754 per bottle of 30 tablets. This process could require the healthcare provider to submit documentation that Januvia is necessary.

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Insurance Insurance Coverage Documentation 52

The Checkup by Singlecare

DECEMBER 31, 2024

According to Dr. Jones, Quviviq may not be covered by your insurance in some instances. Insurance coverage can be tricky, as some health plans may cover a certain medical service or prescription medication, and others may noteven if theyre under the same company. It all depends on how it’s treated by insurance plans.

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Insurance Insurance Coverage Documentation FDA 52

DiversifyRx

MARCH 27, 2025

Many pharmacies lose money when billing insurance for name-brand diabetic testing supplies. Ensure you only purchase from an AD for supplies that you bill to any third-party insurance. Ask for EIN, 501(c)(3) documentation, and referencesbut know that these can even be faked. Its your license on the line.

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Inventory Audits Insurance Documentation 52

The Checkup by Singlecare

MARCH 10, 2025

The cost of semaglutide can vary on whether youre getting a brand-name or compounded version and whether you have insurance coverage. A monthly supply of semaglutide ranges from about $129$1,850 without insurance. Is semaglutide covered by insurance? Does insurance cover Ozempic? Does insurance cover Wegovy?

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Compounding Insurance Insurance Coverage FDA 52

The FDA Law Blog

DECEMBER 4, 2023

Pharmacists and pharmacy management should pay heed to these prescribing red flags, resolve them when they appear and document their resolution. The order also enjoins the pharmacist-owner from serving as a PIC at any other pharmacy for seven years. Consent Agreement and Final Judgment ¶ 17.

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Controlled Substances Documentation Prescription Filling Dosage 139

The Checkup by Singlecare

JUNE 12, 2024

There are no over-the-counter (OTC) equivalents or comparable alternatives, and insurance coverage of Zepbound can be difficult to navigate for some. Is Zepbound covered by insurance? Insurance coverage of Zepbound and many other weight loss medications may require many steps. How much does Zepbound cost without insurance?

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Insurance Insurance Coverage Documentation FDA 52

The Checkup by Singlecare

DECEMBER 31, 2024

Most people who have some type of health insurance receive coverage for Aimovig. says 87% of patients with a commercial insurance plan, Medicare, or Medicaid have coverage for Aimovig. However, Amgen doesnt indicate just how much coverage these insured individuals receive. Does Medicaid cover Aimovig? How much does Aimovig cost?

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Insurance Dosage Documentation FDA 52

STAT

JUNE 20, 2023

Some consulting firms often are getting paid more — a lot more — by the PBMs and health insurance carriers that they are supposed to scrutinize than by companies they are supposed to be looking out for.

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Insurance Documentation 125

The Checkup by Singlecare

APRIL 5, 2024

Insurance companies and Medicare prescription drug plans may cover Ozempic when it’s prescribed for Type 2 diabetes, not weight loss, but it depends on the specific plan. The insurance landscape for Ozempic and similar medications is constantly in flux, and it might feel difficult to keep up with the changes.

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Insurance Documentation Insurance Coverage Pharmaceutical Companies 78

STAT

MARCH 11, 2024

Food and Drug Administration approved a label expansion for Novo Nordisk’s obesity drug Wegovy to tout its benefits for the heart, a move that could boost demand and insurance coverage for the already highly popular treatment , STAT notes. The  Continue to STAT+ to read the full story…

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Insurance Coverage Labelling Documentation Insurance 113

The Checkup by Singlecare

DECEMBER 26, 2023

How much does an MRI cost without insurance? You may have to pay the full price if you don’t have health insurance. How much does an MRI cost with insurance? How much does an MRI cost with insurance? But to ensure that your insurance provider will help cover the costs, you may need to meet your deductible first.

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Insurance Insurance Coverage Hospitals Mayo Clinic 64

The Checkup by Singlecare

MAY 28, 2024

Without insurance, the average retail price for two FreeStyle Libre 2 Sensors is $235. Is FreeStyle Libre 2 Sensor covered by insurance? Most commercial insurance plans cover FreeStyle Libre 2 Sensor, but it depends on the individual plan. How much does a FreeStyle Libre 2 Sensor cost without insurance?

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Insurance Documentation FDA 52

The Checkup by Singlecare

SEPTEMBER 7, 2023

Step therapy focuses on using cost-effective treatments for various conditions, which may help save money in the long run for insurance companies and the people they cover. Step therapy is a process used by health insurance companies to manage and control prescription drug costs. Which insurance plans use step therapy?

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Insurance Health Insurance Companies Documentation Communication 97