STAT

JANUARY 7, 2025

The advent of the first generic GLP-1 drugs could help Medicare negotiate a lower price for the highly sought after diabetes and obesity medication semaglutide , according to experts familiar with the price-negotiation program and STAT’s review of documents from the first round of negotiations.

Documentation 118

Documentation Insurance FDA 118

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.

Insurance 83

Insurance Documentation 83

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.

Hospitals 126

Hospitals Documentation Insurance 126

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.

Insurance 72

Insurance Insurance Coverage Dosage Independent Pharmacies 72

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.

Health Insurance Companies 145

Health Insurance Companies Insurance Documentation 145

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…

Hospitals 140

Hospitals Documentation Insurance 140

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.

Documentation 142

Documentation Insurance 142

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.

Health Insurance Companies 108

Health Insurance Companies Insurance Documentation 108

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.

Health Insurance Companies 116

Health Insurance Companies Documentation Insurance 116

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.

Insurance 106

Insurance Documentation 106

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.

Insurance 98

Insurance Documentation FDA 98

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.

Communication 95

Communication Insurance Documentation 95

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.

Insurance 52

Insurance Insurance Coverage Documentation 52

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?

Insurance 52

Insurance Insurance Coverage Documentation FDA 52

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.

Hospitals 111

Hospitals Health Insurance Companies Documentation Insurance 111

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.

Insurance 64

Insurance Insurance Coverage Hospitals Mayo Clinic 64

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…

Documentation 89

Documentation Insurance Hospitals 89

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.

Insurance 52

Insurance Insurance Coverage Documentation FDA 52

The Checkup by Singlecare

DECEMBER 5, 2022

Is naproxen covered by insurance? | How much does naproxen cost without insurance? | How to get naproxen without insurance. Is naproxen covered by insurance? OTC naproxen, like most OTC drugs, is generally not covered by health insurance. How much does naproxen cost without insurance? SingleCare price.

Insurance 52

Insurance Dosage Documentation FDA 52

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?

Insurance 52

Insurance Documentation FDA 52

The Checkup by Singlecare

JANUARY 13, 2025

Is Basaglar Kwikpen covered by insurance? Basaglar Kwikpen is often covered by insurance, but it depends on the specific plan. Eli Lilly and Company , the manufacturer of Basaglar Kwikpen, says that 97% of people who have private insurance pay $0$95 per month, while 86% of Medicare Part D beneficiaries pay the same amount.

Insurance 52

Insurance Insurance Coverage Dosage Documentation 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?

Insurance 97

Insurance Health Insurance Companies Documentation Communication 97

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.

Insurance 131

Insurance Documentation Packaging 131

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.

Documentation 98

Documentation Insurance 98

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?

Insurance 52

Insurance Dosage 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.

Inventory Audits 52

Inventory Audits Insurance Documentation 52

The Checkup by Singlecare

JULY 16, 2024

If you’ve been prescribed Mounjaro, you may ask whether your insurance will cover it. First, you need prescription drug coverage as part of your insurance plan if you’re hoping to have it cover Mounjaro. Step therapy : You might need to try other medications first before your insurance will pay for Mounjaro.

Insurance 96

Insurance Insurance Coverage Prescription Filling Customer Service 96

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.

Insurance 78

Insurance Documentation Insurance Coverage FDA 78

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.

Documentation 143

Documentation Patient Care Hospitals Insurance 143

The Checkup by Singlecare

DECEMBER 28, 2023

Does insurance cover Ozempic for weight loss? Because Ozempic is currently approved by the FDA for only diabetes management, health insurance plans are unlikely to cover the prescription medication for off-label uses such as weight loss. Some providers may require lab tests or documentation of previous weight loss efforts.

Insurance 104

Insurance Insurance Coverage FDA Documentation 104

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.

FDA 95

FDA Documentation Insurance 95

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.

Documentation 145

Documentation Pharmaceutical Companies Pharmaceutical Companies Insurance 145

The Checkup by Singlecare

FEBRUARY 7, 2023

The rising cost of living in the United States is making it harder to pay for prescription medicines, even among individuals with health insurance. PAPs are programs that help people with no health insurance and those who are underinsured pay for their medications. Here’s how they work. How do patient assistance programs work?

Insurance 98

Insurance Insurance Coverage Pharmaceutical Companies Pharmaceutical Companies 98

pharmaphorum

JANUARY 27, 2023

While SaveOnSP is the nominal target of the lawsuit, it claims to expose one of the failings in the US health insurance sector, adding fire to an increasingly heated exchange between pharma manufacturers and pharmacy benefit managers (PBMs), which have blamed each other for high medicine prices in the US.

Specialty Pharmacies 105

Specialty Pharmacies Insurance Health Insurance Companies Documentation 105

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.

Nursing Homes 145

Nursing Homes Documentation Insurance 145

The Checkup by Singlecare

APRIL 5, 2024

Many patients look to health insurance or Medicare for help with Mounjaro’s out-of-pocket price. And when it’s prescribed for diabetes, not weight loss, insurance often delivers. Like many prescription drugs, without insurance coverage, Mounjaro isn’t cheap. However, it depends on the provider and plan. Does BCBS cover Mounjaro?

Insurance 90

Insurance Insurance Coverage Documentation FDA 90

The Checkup by Singlecare

APRIL 17, 2024

At first glance, Mounjaro might look pretty pricey, but its out-of-pocket costs can vary drastically based on insurance coverage, discounts, pharmacy location, and more. Without help from a health insurance plan, Medicare Part D, or Medicaid, the drug’s list price is $1,069.08 How much does Mounjaro cost? Does Medicaid cover Mounjaro?

Insurance 98

Insurance Insurance Coverage Compounding Pharmacies Compounding 98