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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. ....

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Listen Back To The Friday Show, April 30, 2021

White Bird Crisis Line and crisis center: https://whitebirdclinic.org/crisis
The Alliance for Community Wellness offers FREE telehealth drop-in counseling for trans/gender diverse folks! The service is available Mondays from 12 to 2pm, Tuesdays from 11am to 12pm, and Thursdays from 9 - 11am. Call or text (541) 321-0453 with questions. Let us know if you need a phone or tablet to access the program.
therapists with current openings: G Street Integrated Health and Applegate Counseling (541)344-5978
Upcoming Covid-19 vaccine clinics with Lane County Public Health:
This weekend (~4,800 total boost):
Sat 5/1 at Autzen, 2,400 Pfizer boost
Sun 5/2 at Autzen, 2,400 Pfizer boost
Next week: ....

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Why commercial insurers see new opportunity in ACA exchanges

Why commercial insurers see new opportunity in ACA exchanges
Modern Healthcare Illustration / Getty Images
After a rocky start marked by losses, legal challenges and a general feeling of uncertainty, health insurers are increasingly expanding their footprint on Affordable Care Act exchanges.
During its investors day on March 8, Cigna announced that it plans to double its geographic coverage on the individual market to 20 states by 2025. UnitedHealthcare and Aetna are also reentering the space. While a few regional insurers entered the ACA for the first time in 2021, the majority of payers getting back into the exchange are larger and for-profit insurers, according to Ceci Connolly, president of the Alliance for Community Health Plans, adding competition to the long-time regional holdouts. ....

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Oakland plan to replace police with mental health workers in disarray

Oakland plan to replace police with mental health workers in disarray
sfchronicle.com - get the latest breaking news, showbiz & celebrity photos, sport news & rumours, viral videos and top stories from sfchronicle.com Daily Mail and Mail on Sunday newspapers.

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Plan to replace Oakland police in mental health calls stalls

OAKLAND, Calif.
A pilot program in Oakland to dispatch counselors and paramedics to mental health crises, instead of armed law enforcement officers, that was scheduled to start in January is having trouble getting off the ground.
The Oakland City Council in June voted to set aside $1.85 million to fund the program amid protests against police brutality that followed the killing of George Floyd. But eight months later, the Mobile Assistance Community Responders of Oakland program is in disarray after two community-based organizations that were vying for the contract bowed out this week, the San Francisco Chronicle reported Friday.
Earlier this month, a battle flared up over which nonprofit would receive taxpayer funds to handle duties that have long fallen on sworn police officers. ....

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