A Republican lawmaker has gone after UnitedHealthcare over its Medicare plan, calling the insurance company the "worst offender" in the industry. North Carolina Republican Rep. Greg Murphy on Fox Business on Monday discussed Republicans' efforts to reduce Medicare and Medicaid fraud, saying that UnitedHealthcare was "pushing" the boundaries of Medicare fraud. Newsweek spoke with experts about Murphy's comments.
Physical therapy providers are losing a reimbursement battle with Blue Cross Blue Shield of Michigan, and one of metro Detroit's largest clinic chains says it may close or consolidate more locations if The Blues doesn't let up on the financial squeeze. Blue Cross is starting a new billing policy April 1 for physical therapy providers that, by the health insurer's calculation, would result in an average 17% reimbursement cut for PT clinics.
An inaugural report by the New York City Health Department aimed at cracking down on sky-high prices hospitals charge patients has gaping holes in it because the Big Apple's largest public-employee insurer refuses to turn over records, officials said. The 263-page report quietly released Friday through the agency's new Office of Healthcare Accountability says hospital prices are wildly inconsistent. The study focused on payments made through the city's health care provider, Anthem Blue Cross, and not private-sector insurance plans. The city's GHI-Comprehensive Benefits Plan through Anthem paid on average $45,150 for inpatient services last fiscal year at New York's top 10 hospital systems.
UnitedHealth Group Inc.'s drug-benefits unit is starting to reimburse pharmacies more for dispensing brand-name medicines to address longstanding complaints that expensive prescriptions are losing money for drugstores. PBMs have traditionally compensated pharmacists more for cheaper generic medicines to encourage their use, said Patrick Conway, CEO of UnitedHealth's Optum Rx unit. But generic adoption has plateaued, and Conway said the old system discouraged some pharmacies from stocking newer branded drugs like diabetes and weight-loss shots.
Optum Rx — which includes the PBM of healthcare conglomerate UnitedHealth Group — is dropping annual reauthorization requirements for 80 drugs, which will eliminate more than 10% of overall pharmacy prior authorizations.
A partnership between AARP, the top interest group in the United States dedicated to the plight of seniors, is facing growing scrutiny over its partnership with UnitedHealthcare as the healthcare giant faces a growing number of controversies. "AARP now makes over a billion dollars a year in corporate royalties, more than triple what they make in membership dues," American Commitment President Phil Kerpen told Fox News Digital. "The vast majority of those royalties come from the country's largest insurance company, UnitedHealthGroup, via a skim of 5% of the monthly premiums in the AARP-branded UnitedHealth insurance products. AARP's lobbying work always advances the interests of UnitedHealth rather than seniors. Seniors, for instance, overwhelmingly opposed the Inflation Reduction Act, but UnitedHealth loved its price controls and supersized Obamacare subsidies, so AARP went all out for it." AARP began a partnership with UnitedHealth in 1997 where AARP offers its nearly 38 million members UnitedHealth Medicare-related products, with AARP branding in what Forbes reported amounted to a "marketing coup."