UnitedHealthcare Will Ax Around 20% Of Existing Prior Authorizations
The changed policy, which will affect commercial, Medicare Advantage, and Medicaid members, will begin in the third quarter and will mean providers merely have to notify the insurer about pending care. Among other news, a debate over how to fund the 988 crisis line amid growing demand.
Modern Healthcare:
Prior Authorization Revamped By Cigna, UnitedHealth Group
UnitedHealthcare will eliminate nearly 20% of existing prior authorizations beginning in the third quarter for its commercial, Medicare Advantage and Medicaid members, the insurer announced Wednesday. Next year, UnitedHealth will implement a "gold card" program through which qualifying providers will simply notify the insurer about pending care rather than request prior authorization. This will eliminate the need for prior authorization in most cases, according to the company. (Tepper, 3/29)
In other health care industry news —
Stateline:
As 988 Crisis Line Sees More Use, States Debate How To Pay For It
Almost everyone agrees that putting money behind the national suicide and crisis hotline is a good thing. But not everyone thinks a new phone tax is the best way to pay for it. Since the crisis line’s easy-to-remember 988 number launched last July, its use has increased significantly. The lifeline had 404,194 calls, chats and texts in February alone, an increase of 161,678 contacts over February 2022. (Straub, 3/29)
The Boston Globe:
Understaffing A Major Reason Why A Fifth More Nurses Could Leave The Field
Nearly a fifth of nurses in Massachusetts plan to leave the field in two years or less, according to a survey released Wednesday by the Massachusetts Nurses Association. The departures are likely to further strain already stressed hospitals, which spent $1.5 billion last year on temporary labor, 610 percent more than in the fiscal year that ended in September 2019. (Bartlett, 3/29)
Reuters:
Michigan Health System To Pay $69 Mln Over Claims Of Illegal Referrals
Covenant Health System, which operates more than 20 healthcare facilities in Michigan, and two doctors have agreed to pay more than $69 million to settle claims by federal and state authorities that doctors provided referrals to Covenant in exchange for kickbacks. The settlements, announced on Wednesday by Eastern District of Michigan U.S. Attorney Dawn Ison, stem from a whistleblower lawsuit filed in 2012 by Stacy Goldsholl, a doctor who worked at Covenant for five years. Goldsholl will receive about $12.4 million from the settlements, according to Ison's office. (Pierson, 3/29)
Axios:
CVS Health Expands To The Home With $8B Signify Health Deal
With its $8 billion acquisition of medical services provider Signify Health in the books, CVS Health is expanding its footprint into home health, CEO Karen Lynch said Wednesday at Axios' What's Next Summit. Why it matters: CVS is among the retail giants in an arms race to add capabilities like primary care or telehealth across the health care continuum. It's vying with Amazon, Walmart, Dollar General and Walgreens, among others. (Reed, 3/29)
Modern Healthcare:
ViVE 2023: SVB Collapse Making Digital Health Leaders Cautious
The aftermath of Silicon Valley Bank’s failure is a trending topic among digital health executives and investors this week at the ViVE 2023 in Nashville, Tennessee. The gathering of digital health companies, investors and provider executives is the first large, industry-specific conference since the bank failed on March 10. The event has around 7,500 attendees, according to organizers. (Perna, 3/29)
