Christi Grimm interview, Crisis at HHS, Medicare rates
That’s it for this week’s Health Care Inc. newsletter. Look out for next week’s edition for more updates on the health care industry.
The American Medical Association has issued a letter to UnitedHealth, urging them to hold off on collecting payments until the physician deems it appropriate. The letter emphasizes that physicians have relied on UnitedHealth’s statements and need the flexibility to determine the timing of payments.
In 2021, Medicare Advantage insurers generated $33 billion by adding diagnosis codes to patients’ medical records. UnitedHealth alone accounted for 42% of that total revenue. This practice has raised concerns about the accuracy and appropriateness of diagnosis coding in healthcare.
Republicans, who have traditionally supported Medicare Advantage, are now calling for reforms to the program. Rep. Mike Kennedy of Utah, a family medicine doctor, shared his frustration with UnitedHealth’s HouseCalls program reports, stating that he often disregarded the information due to its lack of relevance.
In Arkansas, lawmakers are considering legislation to prohibit pharmacy benefit managers from owning mail-order or retail pharmacies. This move aims to address potential conflicts of interest and ensure fair competition in the pharmacy industry.
Meanwhile, employee-led lawsuits targeting employers for inflated drug spending have faced challenges in court. Attorneys representing these employees are modifying their arguments to address judges’ concerns and improve the chances of success in these cases.
In the healthcare industry, ongoing debates and legal battles continue to shape the landscape of medical services and insurance practices. It is crucial for stakeholders to collaborate and address issues to ensure transparency, fairness, and quality care for patients.
