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STAT+: Private Medicare plans erect barriers to rehab care in pursuit of profit, federal investigators find
The nation’s dominant Medicare Advantage insurers denied rehabilitative care for older and disabled Americans at higher rates than industry peers, then frequently overturned those denials when patients appealed, federal investigators found. The pattern reinforces longstanding concerns that insurers like UnitedHealth Group and Humana are profiting by forcing seriously ill and injured adults 65 and older to fight for care recommended by their doctors.
These health plans hired a UnitedHealth subsidiary called NaviHealth to evaluate requests for rehabilitative care. NaviHealth uses artificial intelligence to examine people’s care needs and was the focus of a STAT investigative series in 2023 that found its denials often resulted in poor outcomes for desperately ill patients.
Now, federal investigators are reporting the insurers themselves concluded NaviHealth’s denials often didn’t stand up to scrutiny. When patients appealed their blocked care, the insurers overturned the company’s denials of nursing home care 97% of the time, according to a report from the Office of Inspector General for the Health and Human Services Department.
The nation’s dominant Medicare Advantage insurers denied rehabilitative care for older and disabled Americans at higher rates than industry peers, then frequently overturned those denials when patients appealed, federal investigators found. The pattern reinforces longstanding concerns that insurers like UnitedHealth Group and Humana are profiting by forcing seriously ill and injured adults 65 and older to fight for care recommended by their doctors.
These health plans hired a UnitedHealth subsidiary called NaviHealth to evaluate requests for rehabilitative care. NaviHealth uses artificial intelligence to examine people’s care needs and was the focus of a STAT investigative series in 2023 that found its denials often resulted in poor outcomes for desperately ill patients.
Now, federal investigators are reporting the insurers themselves concluded NaviHealth’s denials often didn’t stand up to scrutiny. When patients appealed their blocked care, the insurers overturned the company’s denials of nursing home care 97% of the time, according to a report from the Office of Inspector General for the Health and Human Services Department.
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An obesity drug deep-dive, and peptides move mainstream
Can any of the new obesity medications in development stand out from the pack? Which company just broke records with its IPO? And will the Food and Drug Administration allow greater access to experimental peptides?
We discuss all that and more on this week’s episode of “The Readout LOUD,” STAT’s biotech podcast.
Can any of the new obesity medications in development stand out from the pack? Which company just broke records with its IPO? And will the Food and Drug Administration allow greater access to experimental peptides?
We discuss all that and more on this week’s episode of “The Readout LOUD,” STAT’s biotech podcast.
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RFK Jr. claims his calendar is publicly available. We’ve been trying to get it for a year
WASHINGTON — Health secretary Robert F. Kennedy Jr. on Wednesday pointed to his “publicly available calendar” as an example of his commitment to transparency and to beat back unfavorable reporting.
But no such calendar, detailing who Kennedy meets with or how he spends his time, has been released by the administration. STAT has been asking the Department of Health and Human Services for Kennedy’s calendar for more than a year, via Freedom of Information Act requests and emails to the press office.
WASHINGTON — Health secretary Robert F. Kennedy Jr. on Wednesday pointed to his “publicly available calendar” as an example of his commitment to transparency and to beat back unfavorable reporting.
But no such calendar, detailing who Kennedy meets with or how he spends his time, has been released by the administration. STAT has been asking the Department of Health and Human Services for Kennedy’s calendar for more than a year, via Freedom of Information Act requests and emails to the press office.
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Nonprofit buys experimental cancer drug to maintain patient access
In a rare move, nonprofit organization Blood Cancer United announced Thursday it was buying the remaining supplies of Luvelta, a discontinued investigational cancer drug.
As part of the transaction, Blood Cancer United, previously known as the Leukemia & Lymphoma Society, will also acquire the investigational new drug designation and manage the compassionate-use program for children with a rare form of blood cancer, distributing the medication to patients at no cost while supplies last.
In a rare move, nonprofit organization Blood Cancer United announced Thursday it was buying the remaining supplies of Luvelta, a discontinued investigational cancer drug.
As part of the transaction, Blood Cancer United, previously known as the Leukemia & Lymphoma Society, will also acquire the investigational new drug designation and manage the compassionate-use program for children with a rare form of blood cancer, distributing the medication to patients at no cost while supplies last.
Illinois’ financial crisis could bring the state to a halt
The final 6 ‘Game of Thrones’ episodes might feel like a full season
New Season 8 Walking Dead trailer flashes forward in time
Mod turns ‘Counter-Strike’ into a ‘Tekken’ clone with fighting chickens
Meet Superman’s grandfather in new trailer for Krypton
Disney’s live-action Aladdin finally finds its stars
An obesity drug deep-dive, and peptides move mainstream
RFK Jr. claims his calendar is publicly available. We’ve been trying to get it for a year
Nonprofit buys experimental cancer drug to maintain patient access
Potential Cocaine Addiction Targets Identified Through Genetic Mapping in Rats
New mRNA Delivery Platform Restores Muscle Function in DMD Models
STAT+: Abridge inks deals with Nvidia and Lilly
Illinois’ financial crisis could bring the state to a halt
The final 6 ‘Game of Thrones’ episodes might feel like a full season
New Season 8 Walking Dead trailer flashes forward in time
Mod turns ‘Counter-Strike’ into a ‘Tekken’ clone with fighting chickens
Meet Superman’s grandfather in new trailer for Krypton
Disney’s live-action Aladdin finally finds its stars
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