Latest news with #OliverContreras
UPI
10 hours ago
- Health
- UPI
American insurers to optimize prior authorizations
A group of major health care insurers, including Humana, whose CEO Bruce Broussard is pictured here, agred to streamline the prior authorizations process. File Photo by Oliver Contreras/UPI | License Photo June 23 (UPI) -- Major American insurers announced Monday that they have agreed to speed up and smooth out the processes involved with the reception and administration of health care by streamlining the prior authorization process. The AHIP health insurance industry trade association explained in a press release that dozens of large insurers such as Blue Cross Blue Shield, Humana, Cigna and UnitedHealthCare have voluntarily agreed to "streamline, simplify and reduce prior authorization," a move intended to better connect patients to necessary care while cutting down on the clerical loads of providers. "The health care system remains fragmented and burdened by outdated manual processes, resulting in frustration for patients and providers alike," said AHIP President and CEO Mike Tuffin. According to the companies, 257 million Americans should benefit from the changes, which will be implemented across markets, and include commercial coverage and some Medicare and Medicaid plans. "Health plans are making voluntary commitments to deliver a more seamless patient experience and enable providers to focus on patient care, while also helping to modernize the system," he added. Prior authorization requires that providers attain approval from a patient's insurance company before they can conduct services or treatments. The press release said that such authorizations can lead to the denial or delays of medically necessary care, while also causing "physician burnout." The plan is to create a "common standard" in regard to the submission of electronic prior authorization requests by the beginning of 2027, at which point at least 80% of authorization request approvals will be receive real time responses. Individual plans will also reduce claim types that are subject to prior authorization requests by 2026. "We are encouraged by this collective commitment to reform prior authorization practices," said Executive Vice President and CEO of the American Academy of Family Physicians Shawn Martin. "Physicians have long advocated for reforms that help ensure that patients receive timely, medically necessary care and reduce administrative burden, including the elimination of unnecessary prior authorizations." However, prior authorizations aren't going away, and insurers involved with the change are scheduled to meet with U.S. Heath and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services Administrator Mehmet Oz Monday.
Yahoo
04-02-2025
- Business
- Yahoo
Federal funding freeze: A reminder of why budgets matter
Snow falls on the North Lawn of the White House, Monday, Jan. 6, 2025. (Official White House photo by Oliver Contreras) Last week's attempted federal funding freeze caused panic for the many Kentuckians whose lives, jobs and communities rely on those resources. But that was just a glimpse of what's to come if the Trump administration and Congress move forward with plans to permanently cut the federal budget and hand tax cuts to the wealthiest among us. Federal funds sent to the Kentucky state budget totaled $22 billion in 2024. That equals 43% of state spending, the sixth-largest share of all states. And that's only a portion of the federal tax dollars that flow through our communities. Vital federal grants and payments go to individuals and families, businesses, nonprofit organizations, health care providers, colleges and universities, cities, counties and more. Kentucky also has 23,000 federal civilian employees, making the U. S. government among our state's biggest employers. The threat of lost services and jobs forced the White House to quickly rescind the blanket freeze while still blocking certain grants. The legality of their actions remains highly doubtful, and now the world's richest man, Elon Musk, has apparently seized access to the U. S. Treasury's payment systems with unknown consequences. Congressional leaders' plans for the federal budget are the next deep concern. Their top priority is to make permanent the 2017 tax cuts that go overwhelmingly to the richest people. In Kentucky, the richest 1% would receive $34,440 annually next year while the poorest 20% get only $70. When it comes to the budget, Congress is considering ideas straight out of the Project 2025 report released by the billionaire-funded Heritage Foundation. Official documents suggest major targets for cuts include Medicaid, SNAP food assistance and public schools, among other critical areas. Medicaid covers one in three Kentuckians, including seniors in nursing homes, low-wage workers, people with disabilities and nearly half of Kentucky's kids. The $15 billion a year Kentucky receives through Medicaid props up hospitals and health care clinics across the state. Slashing it would threaten jobs that keep local economies afloat and worsen well-being in a place where life expectancy is already six years shorter than the healthiest states. SNAP helps 587,000 Kentuckians meet basic food needs, including children, low-wage workers, people with disabilities and seniors. New cuts would hit even as inflation has harmfully pushed up the price of groceries 27% in recent years. Bird flu outbreaks — the very kind of diseases we need a properly funded federal public infrastructure to handle — have made the price of eggs go even higher recently. And potential new tariffs on Mexico and Canada threaten to jack food prices up further. Federal funding for public schools is among the array of other budget items on the chopping block under the Project 2025 playbook. The biggest pot of money is Title 1, which provides funding to schools with more low-income children. In Kentucky, 80% of schools rely on Title 1 funding. Cuts would set back kids already facing disadvantages across rural and urban communities. Many of the cuts being considered would shift substantial costs to states. In Kentucky, the General Assembly's reductions to the state income tax will weaken our ability to pay for current services, but the burdens would rise further if a federal cost shift occurs. There are also big questions about many other spending areas, including disaster relief that has been vital in a state wracked by tornadoes and flooding and with 24 declared natural disasters in the last decade. Also at risk are recent infrastructure and energy investments from which the commonwealth has been among the biggest beneficiaries. In Kentucky, 1,100 projects have been funded through these new federal laws, creating jobs in nearly every county. Behind the budget debate's technical jargon and political noise are simple yet consequential decisions. The choice is whether to take resources away from the vast majority and hand them to the already wealthy, the last among us in need of even more.
