United To Cut 1,700 Codes From PA
To fulfill its commitment to eliminate 30% of prior authorizations, UnitedHealthcare says it will make 1,700 codes exempt from the process as of October 1. Most of the eliminations are in commercial and individual plans.
Additional article: https://www.fiercehealthcare.com/payers/unitedhealthcare-nix-prior-auth-1700-services-oct-1 and https://www.modernhealthcare.com/insurance/mh-unitedhealthcare-prior-authorization-requirements-codes/
#unitedhealthcare #healthplans #priorauthorization
Hospitals Continue Attacks On Hospital Rule
Hospital groups closed out the comment period on a proposed rule with additional attacks, arguing that the Centers for Medicare and Medicaid Services’ proposals to expand site neutral payments and reduce reimbursement to 340B facilities would have disastrous consequences. It argues it does not have the legal ability to make the 340B change.
#hospitals #340b #siteneutral #medicare
JAMA Says More Complex Disenroll From MA
Researchers from Johns Hopkins University have concluded that development of any new complex medical condition is linked to a 3.3 percentage-point increase in Medicare Advantage (MA) disenrollment, with 2.8 and 0.5 percentage-point increases in switching to traditional Medicare or another MA plan, respectively.
The researchers reviewed a cohort of more than 1 million MA beneficiaries to determine transitions to traditional Medicare or other MA plans. By 2020, 37.3% of people with at least four new complex conditions who had been enrolled in MA in 2019 had disenrolled from their plan.
#medicareadvantage #enrollment
— Marc S. Ryan
