Montana legislators' prior authorization reform push mirrors national trends
Editor's Note Montana legislators are moving to restrict health insurers’ use of prior authorization as frustration over the practice mounts nationwide, KFF News reported February 13. The outlet reports that two Democratic and Republican lawmakers have introduced or are drafting bills for the 2025 Montana Legislature to limit these insurer-mandated…
Rural hospital closures drive up surgical travel times and costs
Editor's Note Ongoing hospital closures are driving up travel times and out-of-pocket costs for rural Americans who need surgery, according to a February 12 report in HealthDay. Citing two recent studies published in Annals of Surgery and JAMA, respectively, the article details how rural hospital closures have forced more patients…
Moody’s downgrades health insurance outlook as medical costs surge
Editor's Note Moody’s Ratings has shifted the health insurance industry’s credit outlook from stable to negative, according to a February 3 article in Fierce Healthcare. According to the article, the downgrade is due to escalating medical costs that outpace reimbursement rates. Analysts project an 8% rise in commercial market spending…
Cigna ties executive pay to patient experience
Editor's Note As part of a larger initiative to ease access to care, insurance giant Cigna is tying compensation for senior leadership directly to customer satisfaction. Modern Healthcare reported the news February 3. The shift is part of a multi-pronged approach that also includes overhauling prior authorization requirements and limiting…
Providers push back on insurance cost-cutting hurdles
Editor's Note Escalating administrative hurdles from insurers are heightening tensions between healthcare payers and providers who criticize the measures for threatening patient care, Modern Healthcare reported January 22. According to the article, policies attracting criticism include stringent prior authorization rules, claims denials, and new fees for appeals. For their part,…
Prosthetic insurance coverage disparities persist despite legal protections
Editor's Note Health insurance coverage of prosthetics remains inconsistent and often inadequate, KFF Health News reported January 6. As a result, many patients face coverage denials due to claims of lack of medical necessity or high costs despite significant advancements in prosthetic technology, such as microprocessor-controlled knees and myoelectric hands.…
Surgical legislation advocacy focuses on safety, access
“Surgeons are the only people trained to provide surgery—life-saving care," says Carrie Zlatos, chief of legislative and political affairs at the American College of Surgeons (ACS). "They are an essential element of a community-based healthcare system. Regardless of where you live, everyone should have access to full quality surgical care.”…
Costs drop, access expands for GLP-1 weight loss drugs
Editor's Note Access to GLP-1 medications is improving as manufacturers, insurers, and policymakers address high demand, costs, and coverage challenges, Becker’s Hospital Review reported December 13. As detailed in the article, Eli Lilly’s partnership with telehealth company Ro now allows patients to obtain Zepbound prescriptions online and receive shipments directly…
Anthem anesthesia payment policy reversal prompts statement from American Society of Anesthesiologists
Editor's Note The American Society of Anesthesiologists (ASA) commended Anthem's reversal of a policy to deny anesthesia payment based on arbitrary time limits, which was set for February 2025 in three states. “The now-rescinded policy was inconsistent with prevailing standards, regulations and billing norms, and revealed a diminished dedication to…
AHA's Congressional "wish list" calls for financial relief, patient access, workforce protections
Editor's Note In a November 12 letter to Congress, the American Hospital Association (AHA) outlined its priorities for the lame-duck legislative session, focusing on measures to stabilize hospitals and health systems facing significant financial and operational pressures. If enacted, these recommendations would support the nation’s healthcare infrastructure amid rising…
Free Daily News
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- Oregon bill seeks to ban AI from using ‘nurse’ title amid patient safety concerns
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- Study: Virtual reality reduces preoperative anxiety in heart surgery patients
- CABG, TAVR drive hospital revenue despite cost variations
- Rural hospital closures drive up surgical travel times and costs
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