Commercial Insurer Accountability
Hospitals and health systems are seeing significant increases in administrative costs, including due to burdensome practices by commercial insurers that often delay and deny care for patients, according to a new report released Sept. 10 by the AHA.
Between 2022 and 2023, care denials increased an average of 20.2% and 55.7% for commercial and Medicare Advantage (MA) claims, respectively.
Lawmakers have returned to Washington for three weeks to consider government funding, which expires Oct. 1. Congress must pass a continuing resolution (CR) by Sept. 30 to avoid a government shutdown.
A Commonwealth Fund report published Aug. 1 examines how frequently insured, working-age adults are denied care by insurers; how often they are billed for services they believed were covered; and their experiences challenging such bills or care denials. The report shows that 45% of insured, working…
ACTION NEEDED: Talk to Lawmakers this August on Important Issues Facing Hospitals and Health Systems
Lawmakers need to hear how congressional support is necessary to ensure hospitals can provide the 24/7 access to care patients and communities depend on.
It is important to use the August recess that begins next week as an opportunity to engage senators and representatives while they are back home. It is critical for federal lawmakers to understand the challenges hospitals and health systems face.
Congress is considering legislation that would change current billing practices for Medicare and the commercial insurance market to require each off-campus hospital outpatient department (HOPD) to be assigned a unique NPI as a condition of payment.
The AHA July 11 released its quarterly Health Care Plan Accountability Update, a roundup of news, letters, statements and other resources covering private insurance plans, Medicare Advantage and related issues.
The AHA May 2 released a new report highlighting how hospitals and health systems continue to experience significant financial pressures that challenge their ability to provide 24/7 care for patients and communities.
UnitedHealth Group’s concentration in the healthcare system is unprecedented. If it were a country, it would rank 42 in the world in Gross Domestic Product.