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STAT+: Biden changes will force health insurers to speed up and get more specific if they want to deny care

STAT

The Biden administration moved Wednesday to force insurance companies to give specific reasons for denying coverage, and to speed up the pre-approval process in general. The new rule applies to health insurance companies that offer Medicare, Medicaid, Children’s Health Insurance Program, and Obamacare plans.

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‘We’ve heard similar commitments before’: CEOs demand action, not promises on prior auth

Beckers Hospital Review

Health insurers covering more than 250 million Americans have unveiled a sweeping plan to streamline and reduce prior authorization requirements — a long-standing source of frustration and burnout for providers and patients. But many hospital leaders argue they’ve heard promises like this before.

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Towards a healthier, more equitable and innovative Indian healthcare sector

Express Pharma

Specific highlights of the budget for the sector include an increase in outlay for research and development and for the Ayushman BharatPradhan Mantri Jan Arogya Yojana (PM-JAY), the government’s universal health coverage scheme, which saw a 10 per cent budget increase to Rs 7,300 crores.

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NHC Submits Comments on CMS’ Proposed Rule on Marketplace Integrity and Affordability

Putting Patients First Blog

While we recognize CMS intent to strengthen program integrity and reduce fraud, we are deeply concerned that several provisions in this rule will create obstacles to coverage, increase out-of-pocket costs, and disproportionately impact vulnerable populations.

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NHC Reconciliation Letter to Congress on One Big Beautiful Bill Act

Putting Patients First Blog

It will also negatively affect access to coverage and care for people that obtain their health coverage through the ACA Marketplace and Medicare. The proposed reconciliation bill heightens the risk that millions of Americans will lose access to care and coverage by shifting even more Medicaid costs to the states.

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RFK Jr looks to alter rare disease regulation by fast-tracking drug approvals

Pharmaceutical Technology

The approval process for cell and gene therapy candidates is tricky, however, given their high-cost and oft-debated benefit-risk ratio. RFK Jr did not question their importance, and acknowledged panellists’ calls for faster regulatory processes. Cell & Gene Therapy coverage on Pharmaceutical Technology is supported by Cytiva.

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Considerations for Hernia Patients when Selecting a Surgeon

Putting Patients First Blog

The Abdominal Core Health Quality Collaborative (ACHQC) believes it is our obligation to listen and offer suggestions to help patients navigate the decision-making process. Choose a surgeon who communicates clearly, listens attentively, and ensures you understand the procedure, potential risks, and recovery process.