When health insurance denies coverage for essential medications, the consequences can be severe. From formulary exclusions to step therapy hurdles, patients face barriers that often contradict clinical best practices.
With Medicare set to run out of funding for telehealth coverage by the end of March, Democratic Representative Ro Khanna of California has introduced the Telehealth Coverage Act to continue the services.
Several community health centers in Connecticut are cutting back on dental care — or eliminating it entirely — due to insufficient Medicaid reimbursement rates, officials there said Monday.
A report from HHS' Office of the Inspector General estimates that Colorado paid insurers at least $7.3 million, consisting of approximately $3.8 million in federal funds, for services for deceased Colorado residents.
Much of the dysfunction in healthcare stems from misaligned incentives and a lack of transparency. Insurers, in their effort to control costs, have prioritized short-term denials over long-term value and positive health outcomes, undermining their own credibility while failing to promote their own customers’ well-being.