Federal Judge Strikes Down ACA’s Preventive Care Coverage Requirements
A federal judge on Thursday struck down the Affordable Care Act (ACA) provision requiring all insurers to cover certain preventive services free of charge, angering the law’s supporters. “Individual Plaintiffs need not comply with the preventive care coverage recommendations of the U.S. Preventive Services Task Force (USPSTF) issued on or after March 23, 2010 [the […]
Senate Committee Puts PBMs Under the Microscope
Pharmacy benefit managers (PBMs) — middlemen between pharmacies, health insurers, and drug companies — are responsible for driving up prescription drug prices and shuttering independent pharmacies, witnesses said during a hearing held by the Senate Commerce, Science, & Transportation Committee. Three of the four witnesses — an economist, a physician, and a pharmacist — called […]
Medicare Advantage Plans Fielded 35 Million Prior Auth Requests in 2021
Over 35 million prior authorization requests were submitted to Medicare Advantage insurers in 2021, according to a new report from the Kaiser Family Foundation (KFF). Two million of these requests, or 6%, were fully or partly denied, according to Jeannie Fuglesten Biniek, PhD, associate director of the Program on Medicare Policy, and Nolan Sroczynski, MSPH, […]