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A letter from the executive editor: STAT’s investigation into a UnitedHealth algorithm

STAT

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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STAT+: Biden administration ignores calls to bolster hospital price transparency

STAT

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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STAT+: UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients’ rehab care

STAT

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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STAT+: ‘Everybody has blood on their hands’: A decade-long battle over Medicare Advantage audits is coming to a head

STAT

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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J&J copay lawsuit against drug benefit firm gets green light

pharmaphorum

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.

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What is step therapy?

The Checkup by Singlecare

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. What is step therapy?

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Latuda vs. lithium: Differences, similarities & side effects

The Checkup by Singlecare

Adults, adolescents, and children 10 years and older Adults, adolescents, and children 7 years and older Latuda vs. lithium: Conditions treated Through rigorous clinical trials and documentation, the FDA approves medications for very specific uses. However, drug costs vary depending on your insurance plan and pharmacy used.