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Health

After outcry, UnitedHealthcare softens prior authorization policy for colonoscopies

02.06.2023

After weeks of protest from physician organizations and patients, UnitedHealthcare has put a controversial new prior authorization policy for gastroenterology procedures on hold. The policy, which requires physicians and patients …

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Health / Pharma

Insurance alone didn’t guarantee adherence to Ozempic, study finds

01.06.2023

Having insurance coverage alone doesn’t guarantee that people can afford or would be willing to pay continuously for chronic disease medications like Ozempic, a new, large-scale study finds. Looking at …

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Health Tech

Senators probing largest Medicare Advantage plans over how algorithms factor in care denials

18.05.2023

Senators warned the country’s largest Medicare Advantage insurers at a hearing on Wednesday that they must abide by Medicare’s coverage rules and cannot rely on algorithms to deny care that …

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Health

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

15.05.2023

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 …

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Health Tech

A former health insurance executive turns to tech to make claims less of a nightmare

11.05.2023

You’re reading the web edition of STAT Health Tech, our guide to how tech is transforming the life sciences. Sign up to get this newsletter delivered in your inbox every Tuesday and …

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Pharma

Drugmakers push back on a clever tactic employers use to avoid paying for specialty medicines

22.03.2023

In the face of rising drug prices, health plan sponsors have quietly used a clever, but questionable tactic over the past few years to deflect costs. And now, some pharmaceutical …

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Health Tech

Denied by AI: How Medicare Advantage plans use algorithms to cut off care for seniors in need

13.03.2023

An algorithm, not a doctor, predicted a rapid recovery for Frances Walter, an 85-year-old Wisconsin woman with a shattered left shoulder and an allergy to pain medicine. In 16.6 days, …

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Pharma

‘Caught in the middle’: A battle between Vertex and insurers is leaving cystic fibrosis patients with crushing drug costs

20.02.2023

Dan Brickey was stunned when he learned the news. The cost of the cystic fibrosis medicine that his 2-year-old daughter, Ali, had recently started taking was about to climb from …

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First Opinion

Opinion: Reinventing health care in 2023

25.01.2023

After a year defined by record inflation and double-digit health care premium increases, I hope that a few years down the road we can eventually look back at 2023 as …

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