A proposal in the North Carolina legislature would protect patients from surprise ambulance bills. Critics worry it's written in a way that will drive up healthcare costs — and maybe insurance premiums.
The health plan that covers some 750,000 current and former state employees and their families has hit a stone wall in negotiations with its pharmacy benefit manager, CVS Caremark, and is pondering legal action against the company, the Office of the State Treasurer announced on June 5. The company owes the state tens of millions of dollars and is trying to rewrite their contract to get out of having to pay it back.
By prolonging the search for a provider, ghost networks can delay patients' ability to get diagnosed and treated, or cause them to forgo care altogether. But regulatory efforts to force insurance companies to update their directories or penalize them for inaccurate provider information have fallen short, prompting some patients to turn to the courts.
An internal document drafted in advance of UnitedHealth Group's shareholder meeting this week reveals how the company's leadership — facing an extraordinary series of financial and legal challenges — sought to downplay complaints about its business practices and assure jittery investors that it will soon return to maximum profitability. The 18-page document, marked in red 'privileged and confidential,'' offers a rare, behind-the-scenes look at the nation's most powerful health care conglomerate as it endures arguably the most difficult stretch in its nearly 50-year history. The last six months have been punctuated by government investigations, a tanking stock price, and the brazen killing of a top executive on a Manhattan street before the annual investor conference last December. UnitedHealth's document, labeled as a draft and dated May 29, runs through manicured talking points apparently intended to coordinate the response to shareholders' questions. Specifically, the document shows how Stephen Hemsley, the company's longtime CEO and board chair who shies away from publicity, is navigating the leadership shakeup since retaking the reins last month. Investors have raised pointed concerns over his $60 million pay package. It also discusses missed revenue targets, a litany of lawsuits and federal investigations, and concerns revealed in reporting by STAT that the company uses AI and bureaucratic barriers to delay and deny care.
CMS Administrator Mehmet Oz defended President Trump’s 'big, beautiful bill' over criticism that millions of people could lose health coverage, saying those who would face new work requirements should 'prove that you matter.' Oz made the comments during an interview on Fox Business, arguing that when Medicaid was created in the 1960s lawmakers did not include work requirements because it 'never dawned on anybody that able-bodied people who work would be on Medicaid.'
Senate Republicans are eyeing possible Medicare provisions to help offset the cost of their megabill as they try to appease budget hawks who want more spending cuts embedded in the legislation.