All articles tagged with #medical groups
Top medical groups are concerned that Health and Human Services Secretary Robert F. Kennedy Jr. may dismiss the U.S. Preventive Services Task Force, an influential advisory panel on primary care, raising fears about the loss of trusted guidelines and potential political interference in preventive health recommendations.
Two influential medical groups with San Diego-based Scripps Health are canceling their Medicare Advantage contracts for 2024 due to low reimbursement and prior authorization issues, leaving 30,000 enrolled seniors to find new doctors or different coverage. The CEO of Scripps Health cited annual losses exceeding $75 million as the reason for the withdrawal, emphasizing that the losses are unsustainable. The affected beneficiaries will receive notices directly from the plans, and they have the option to switch to traditional Medicare or other hospital systems that still accept Medicare Advantage plans. The issue of low reimbursement and prior authorization is a growing concern for physicians and hospitals, leading to more medical groups terminating their Medicare Advantage contracts.
UnitedHealthcare has shifted its approach to endoscopy services, including colonoscopies, from "prior authorization" to "advance notification." The new requirement involves providers submitting patient data to UnitedHealthcare before performing a procedure. Providers who submit advance notifications will be eligible for UnitedHealthcare's Gold Card program, which will eliminate prior authorization requirements for most procedures. The change comes after criticism from medical groups about the prior authorization plan, which could have delayed urgent procedures. Some groups have expressed concern about the "advance notification" process, which they say could create significant administrative and resource burdens for physicians and medical staff.