Where prior authorization stands — and where data still falls short
(By: Elizabeth Casolo for Becker’s Hospital Review) Prior authorization data is now public — but it is not giving much
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Health Insurance
Continuing FEHB coverage in retirement
Federal retirees need to understand how FEHB and Medicare work together to minimize costs and maximize coverage. What federal employees
Read MoreHospital Prepayment Requirements Add New Wrinkles to Patients’ Financial Responsibility
(By Julie Appleby for KFF Health News) Thomas Zordani flew from his home in Denver to Phoenix for a consultation
Read MoreHow Much and Why Premiums Are Going Up for Small Businesses in 2027
(By Emma Wager Twitter, Ashley Ferguson, Matthew McGough, Shameek Rakshit, Imani Telesford, Lynne Cotter, Nirmita Panchal, Matthew Rae Twitter, and
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ACA enrollees are 6.3% sicker as marketplace shrinks: Report
(By: Jakob Emerson for Becker’s Hospital Review) The ACA individual market risk pool is getting smaller and sicker, with risk
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Medicare Advantage provider to pay $14.1M to settle false diagnosis code allegations
(By: Andrew Cass for Becker’s Hospital Review) Jacksonville, Fla.-based management services organization Complete Health Partners Holdings has agreed to pay
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UnitedHealthcare to tighten reimbursement for lab tests
(By: Jakob Emerson for Becker’s Hospital Review) UnitedHealthcare is rolling out new reimbursement limits on five categories of lab tests
Read MoreKennedy, Oz Contend Fraud Crackdown, Not Skyrocketing Prices, Led Millions To Leave Obamacare
(By Julie Appleby for KFF Health News) The Trump administration credits its fraud control efforts for the disappearance of millions
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Senate Democrats eye public option in insurance reform push
(By: Jakob Emerson for Becker’s Hospital Review) Senate Democrats want more information on how to enact private health insurance reforms,
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Humana to exit Medicare Advantage plans covering 600,000 members in 2027
(By: Jakob Emerson for Becker’s Hospital Review) Humana expects Medicare Advantage plan exits next year to affect around 600,000 members
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