Cancer staffing crunch means a summer of travel to Charlottetown for some Western P.E.I. patients
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NIH cuts spotlight a hidden crisis facing patients with experimental brain implants
Carol Seeger finally escaped her debilitating depression with an experimental treatment that placed electrodes in her brain and a pacemaker-like device in her chest. But when its batteries stopped working, insurance wouldn't pay to fix the problem and she sank back into a dangerous darkness. She worried for her life, asking herself: 'Why am I putting myself through this?'
Yahoo
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UnitedHealth Group's (UNH) Healthcare Dominance: A Key Player in the Dogs of the Dow
UnitedHealth Group Incorporated (NYSE:UNH) is included among the 11 Dogs of the Dow Dividend Stocks to Buy Now. A senior healthcare professional giving advice to a patient in a clinic. The stock has dropped over 44% so far this year after reporting weaker-than-expected earnings in the first quarter. The company first reduced its full-year outlook and later chose to withdraw it entirely. Even with the underwhelming Q1 performance, UnitedHealth Group Incorporated (NYSE:UNH) still posted a 9.8% year-over-year increase in revenue, reaching $109.6 billion. It earned a profit of around $6.3 billion during the quarter and maintained a solid financial position, holding close to $34.3 billion in cash and cash equivalents, along with a debt level that remains manageable. The company has added 780,000 new members so far this year. Meanwhile, Optum Health still expects to provide value-based care to an additional 650,000 patients in 2025. In addition, UnitedHealth Group Incorporated (NYSE:UNH) generated $5.5 billion in operating cash flow during the quarter and returned $5 billion to investors through dividends and share repurchases. The company has been rewarding shareholders with growing dividends since 2011 and currently offers a quarterly dividend of $2.21 per share. The stock supports a dividend yield of 3.15%, as of July 26. While we acknowledge the potential of UNH as an investment, we believe certain AI stocks offer greater upside potential and carry less downside risk. If you're looking for an extremely undervalued AI stock that also stands to benefit significantly from Trump-era tariffs and the onshoring trend, see our free report on the best short-term AI stock. READ NEXT: and Disclosure: None. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Forbes
5 hours ago
- Forbes
Changes In Prior Approval Coming To Traditional Medicare, Medicare Advantage
There were two major announcements recently regarding prior approval of treatments and services for Medicare beneficiaries. In most medical insurance, many treatments won't be covered unless it is approved first by the insurer. It's been a source of controversy for some time. Original Medicare hasn't required prior authorization of treatments and services, with a few exceptions. For most care, providers and the patient agree on a treatment. After the treatment, paperwork for approval and payment is submitted to Medicare. Medicare recently announced a new model program that will test pre-approval. The voluntary model program will test pre-approval for some services and treatments, according to a recent announcement from the Center for Innovation of the Centers for Medicare and Medicaid Services. The model program is seeking medical providers to volunteer for the program from Jan. 1, 2026 through Dec. 31, 2031. The model will be restricted to New Jersey, Ohio, Oklahoma, Texas, Arizona, and Washington. Providers who volunteer and are accepted will agree to seek prior authorization for 17 items and services, including skin substitutes, deep brain stimulation for Parkinson's Disease, impotence treatment, and arthroscopy for knee osteoarthritis. A provider who volunteers for the program can choose not to seek prior approval for a case. There will be a post-treatment review of the case, and the provider will risk not being paid by Medicare for the treatment. CMS initiated the program and selected the services to be covered because of a series of reports showing waste, fraud or abuse in certain areas. For example, Medicare spent up to $5.8 billion in 2022 on unnecessary or inappropriate services that had no clinical benefit, according to the Medicare Payment Advisory Commission. Under the model, providers will submit the same information they currently submit for payment approval after a service is provided to a beneficiary. The difference is that under the model, the information will be submitted earlier and the provider will wait for approval before performing the services. CMS will select companies to receive and review the prior authorizations. It expects that they will use artificial intelligence and other tools in addition to medical professionals to review the submissions. The companies will be paid based on the extent to which they saved the government money by stopping unnecessary services. CMS said it will manage the program to avoid adverse impact on beneficiaries and providers. There was other news about pre-approval, this time involving Medicare Advantage plans. Pre-approval in Medicare Advantage plans has been controversial recently. There have been a number of recent reports and studies that found the authorization process was delaying treatment or causing patients to abandon treatment plans. Other reports indicated that a high percentage of treatments that initially were denied coverage eventually were approved if the patients or their providers appealed the than 50 major insurers who sponsor many types of insurance plans announced that they will voluntarily streamline prior authorization of treatments and services in all insurance markets, including Medicare Advantage plans. The insurers say they plan to have the new process in place by Jan. 1, 2027.
