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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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‘Stunning’ change to United’s colonoscopy coverage roils physicians and patients

STAT

When gastroenterologists learned in March that UnitedHealthcare plans to barricade many colonoscopies behind a controversial and complicated process known as prior authorization, their emotions cycled rapidly between fear, shock, and outrage.

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STAT+: Carbon Health blasts a major insurer in rare public dispute over coverage

STAT

— Primary care startup Carbon Health blasted health insurer Elevance on Monday for paying it less than competitors and for also refusing to process out-of-network claims — a rare public escalation of the behind-the-scenes disputes between providers and payers. OAKLAND, Calif.

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Health insurer Excellus will not fund Alzheimer’s drug Aduhelm

pharmaphorum

Health insurer Excellus BlueCross BlueShield has said it will not cover treatment with Biogen and Eisai’s new Alzheimer’s disease drug Aduhelm because it has not been shown to be medically effective. The post Health insurer Excellus will not fund Alzheimer’s drug Aduhelm appeared first on.

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Navigating Pharmacy Insurance Coverage: How to Evaluate Insurance Plans for Your Business

Digital Pharmacist

One effective way to mitigate these risks is by having comprehensive insurance coverage. Determining the coverage needs and evaluating insurance requirements for your pharmacy can ensure you’re adequately protected in the face of any unforeseen circumstances.

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Navigating Health Insurance Coverage for Innovative and Specialty Drugs: Q&A With Maria Kirsch, President of Patients Services at EVERSANA

PharmExec

Kirsch discusses the complexity of the drugs and the verification process, along with EVERSANA’s new platform, ACTICS eAccess.

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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.