A survey released June 4 by the Commonwealth Fund on insurance coverage denials found that 1 in 5 privately insured U.S. adults reported that they or a family member experienced insurance company denials for care recommended by a doctor within the past year. The survey, conducted last year, analyzed responses from nearly 4,600 individuals with private insurance. It found that 41% of people who experienced a prior authorization denial said it led to a delay in medical care, and 28% said a health issue worsened because of it. Only about half who experienced a denial appealed the decision, citing uncertainty about their right to do so and whether it mattered, along with confusion regarding who to contact to file the appeal.

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The 5th U.S. Circuit Court of Appeals Aug. 11 ruled to vacate certain regulations implementing how the No Surprises Act qualifying payment amount is calculated…
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Guidance on the implementation timeline for the No Surprises Act independent dispute resolution operations final rule was released Aug. 7 by the Departments of…
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The U.S. District Court for the Eastern District of Pennsylvania Aug. 5 granted a motion for the AHA and the Hospital and Healthsystem Association of…
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The Department of Labor July 22 released a proposed rule to modernize how group health plans deliver required disclosures. The proposal would create a safe…
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The U.S. District Court for the District of Maryland July 16 enjoined eight provisions from the Centers for Medicare & Medicaid Services’ 2027 notice of…
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Health Insurance Marketplace insurers will propose a median premium increase of 14% for 2027, according to an analysis of preliminary rate filings published…