After Man’s Death Following Insurance Denials, West Virginia Tackles Prior Authorization
After Eric Tennant died, his widow vowed to speak out against West Virginia’s Public Employees Insurance Agency, which had denied cancer treatment recommended by Tennant’s doctor. Her efforts paid off. In March, West Virginia’s governor signed a bill to protect some patients from harm tied to prior authorization.
Cada año millones de pacientes enfrentan negativas a través del proceso de autorización previa, que exige que sus doctores obtengan aprobación anticipada de las aseguradoras antes de continuar con la atención médica.
Families Scramble To Pay Five-Figure Bills as Clock Ticks on Promised Preauthorization Reforms
Last summer, the Trump administration announced a voluntary pledge by health insurers to reform prior authorization, which often requires patients or their doctors to seek preapproval from insurers before proceeding with medical care. Patient advocates and medical providers remain skeptical.
Arizona, Maryland, Nebraska y Texas aprobaron el año pasado leyes que limitan el uso de la IA en los seguros de salud. Otros dos, Illinois y California, habían aprobado leyes similares el año anterior.
Red and Blue States Alike Want To Limit AI in Insurance. Trump Wants To Limit the States.
A revolt is afoot in both red and blue states against the use of artificial intelligence in health insurance determinations — and against efforts led by President Donald Trump to tie states’ hands.
‘Abortion as Homicide’ Debate in South Carolina Exposes GOP Rift as States Weigh New Restrictions
A proposed abortion ban in South Carolina would have allowed the criminal prosecution of women who obtain the procedure. It’s unlikely to become law, but this bill and other proposals across the country show how some conservative lawmakers are embracing increasingly punitive abortion restrictions.
South Carolina’s Measles Outbreak Shows Chilling Effect of Vaccine Misinformation
When a measles outbreak emerged in Spartanburg, South Carolina, in October, health officials announced that most cases were tied to one public charter school, where only 17% of the 605 students enrolled during the 2024-25 academic year provided documentation showing they had received their required vaccinations.
After Series of Denials, His Insurer Approved Doctor-Recommended Cancer Care. It Was Too Late.
Eric Tennant’s doctors recommended histotripsy, which would target, and potentially destroy, a cancerous tumor in his liver. But by the time his insurer approved the treatment, Tennant was no longer considered a good candidate. He died in September.
Paciente evita la enfermedad de Lyme, pero recibe una factura sorpresa
El personal de una clínica de urgencias encontró otra garrapata en el cuerpo de Leah durante esa visita. Pero su aseguradora no quiso pagar por el tratamiento.
Ticked Off Over Preauthorization: Walk-In Patient Avoided Lyme Disease but Not a Surprise Bill
A Maine woman sought care at a clinic for a tick bite, then paid full price after her insurer denied coverage. Its reason? She didn’t have preapproval for the walk-in visit, even though testing later detected the pathogen that causes Lyme disease.
La inteligencia artificial pronto influirá en que te aprueben o te nieguen tratamientos en Medicare
Siguiendo el ejemplo del sector privado de seguros, la administración Trump lanzará el próximo año un programa piloto.
AI Will Soon Have a Say in Approving or Denying Medicare Treatments
A pilot program testing the use of artificial intelligence to expand prior authorization decisions in Medicare has providers, politicians, and researchers questioning Trump administration promises to curb an unpopular practice that has frustrated patients and their doctors.
Fighting a Health Insurance Denial? Here Are 7 Tips To Help
Many people don’t know they can fight a health insurance denial, let alone how to do it. Here are practical tips for consumers who want to appeal a prior authorization decision.
Doulas, Once a Luxury, Are Increasingly Covered by Medicaid — Even in GOP States
Even as states brace for significant reductions in federal Medicaid funding over the next decade, conservative legislatures across the country are passing laws that grant doula access to Medicaid beneficiaries.
5 Takeaways From Health Insurers’ New Pledge To Improve Prior Authorization
Dozens of health insurance companies pledged on Monday to improve prior authorization, a process often used to deny care. The announcement comes months after the killing of UnitedHealthcare executive Brian Thompson, whose death in December sparked widespread criticism about insurance denials.
‘Not Accountable to Anyone’: As Insurers Issue Denials, Some Patients Run Out of Options
Health insurers issue millions of prior authorization denials every year, leaving many patients stuck in a convoluted appeals process, with little hope of meaningful policy change ahead. For doctors, these denials are frustrating and time-consuming. For patients, they can be devastating.
Trump Won’t Force Medicaid To Cover GLP-1s for Obesity. A Few States Are Doing It Anyway.
Late last year, South Carolina Medicaid approved a class of medications known as GLP-1s to treat obesity, placing it among the few state programs covering these effective but expensive drugs. But access remains limited, even for patients covered by Medicaid, because of stringent prerequisites that must be satisfied before starting the drug.
The Patient Expected a Free Checkup. The Bill Was $1,430.
Carmen Aiken of Chicago thought their medical appointment would be covered because the Affordable Care Act requires insurers to pay for a long list of preventive services. But after the appointment, Aiken received a bill for more than $1,400.
‘They Won’t Help Me’: Sickest Patients Face Insurance Denials Despite Policy Fixes
The fatal shooting of UnitedHealthcare CEO Brian Thompson prompted both grief and public outrage about the ways insurers deny treatment. Republicans and Democrats agree prior authorization needs fixing, but patients are growing impatient.
Across the South, Rural Health Care Has Become ‘Trendy.’ Medicaid Expansion Has Not.
State legislatures nationwide, including several in the South, are spending millions to improve rural health outcomes and access. For years, though, most Southern states have refused billions of federal dollars to provide public health insurance to more low-income adults. That isn’t likely to change with Trump back in office.
