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Bill would revamp Medicare Advantage prior authorization

Modern Healthcare Illustration / Getty Images Congress is eying changes to Medicare Advantage that would crack down on prior authorization tactics insurers use to rein in healthcare costs but can affect how providers care for patients. Rep. Susan DelBene (D-Wash.), Mike Kelly (R-Pa.), Ami Bera (D-Calif.) and Larry Bucshon (R-Ind.) reintroduced a bill Thursday that aims to quicken the prior authorization process and require more transparency about how often plans deny providers requests. Healthcare lobbyists believe the proposal could see movement this year. This continues to be a thorn in the side of our practices. It is such an administrative burden, said Drew Voytal, associate director of government affairs for the Medical Group Management Association.

Almost 20 advocacy groups team up to pressure Congress to pass health care bill for immigrants

ADVERTISEMENT But this year, 19 groups are uniting to publicly back the legislation as Democrats have control of the presidency and in both chambers of Congress. Under the bill, immigrants who qualify for Medicaid as well as the Children’s Health Insurance Program can receive coverage without a mandatory five-year waiting period.  The legislation also would permit undocumented immigrants to purchase coverage under the Affordable Care Act’s health insurance exchanges, and it would allow Deferred Action for Childhood Arrivals recipients to get public health care coverage.  The organizations cited a Kaiser Family Foundation report that found noncitizens in the U.S. are more likely to be uninsured, noting a lack of insurance poses an obstacle to getting needed care. 

Pfizer COVID-19 vaccine: CDC panel recommends shots for kids 12 to 15

View Comments Adolescents ages 12 to 15 should get the Pfizer-BioNTech COVID-19 vaccine and they can get their other routine vaccinations along with it, a federal advisory committee said Wednesday. The Centers for Disease Control and Prevention s panel met to discuss the safety, immune response and effectiveness of the vaccine in this age group, after the Food and Drug Administration signed off Monday on the shots. The same Advisory Committee on Immunization Practices last December signed off on the Pfizer-BioNTech vaccine for adults and teens ages 16 to 17.  Fourteen members of the panel on Wednesday endorsed lowering the age limit to 12, with one member recusing herself.

The inhumanity of for-profit healthcare in the age of COVID-19

The inhumanity of for-profit healthcare in the age of COVID-19 Why the American healthcare system is a barbaric, Kafkaesque mess share It’s long past time we confront the shocking barbarity of medical care in America, and fight to create a healthcare system that serves all of us.   According to the Centers for Disease Control (CDC), the federal government is picking up the tab for everyone who wants and needs a COVID-19 vaccine; everybody in the United States, “regardless of their immigration or health insurance status,” can receive a vaccine free of charge. No healthcare provider may charge you for the vaccine, nor charge you any administrative fees or copays. They may not deny a vaccination to people without health insurance. They may not send a vaccine recipient a bill to make up the cost of their visit that insurance did not pay. This is all perfectly reasonable, and many would say the humane thing to do. So why do we not do the same for all healthcare?

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