Latest news with #PPO
Yahoo
6 days ago
- Health
- Yahoo
UnitedHealth to drop Medicare Advantage plans for 600K people
The Brief United Healthcare, the nation's largest provider of Medicare Advantage plans, is dropping certain plans that cover 600,000 people. The plans being dropped are primarily those in which seniors have more choices on health care providers. The decision comes as UnitedHealthcare faces a federal civil fraud investigation into how it records diagnoses that lead to extra payments for its Medicare Advantage plans. UnitedHealthcare says it's dropping some of its Medicare Advantage plans that collectively cover 600,000 people. UnitedHealthcare, owned by UnitedHealth Group, covers more than 8 million people as the nation's largest provider of Medicare Advantage plans. The business has been under pressure in recent quarters due to rising care use and rate cuts. Which Medicare Advantage plans is UnitedHealthcare dropping? What they're saying In an earnings call last week, Tim Noel, the company's health insurance division CEO, said UnitedHealthcare is dropping plans that cover 600,000 members, "primarily in less managed products such as PPO offerings." The plans being dropped are primarily those in which seniors have more choices on health care providers, according to The Spokesman-Review. Noel said its Medicare Advantage members are increasing the number of doctors' visits, tests, specialists and emergency room visits, "contributing to elevated outpatient spend." RELATED: Medicaid, Medicare may cover weight loss drugs under new pilot program: report "Considering the continued cost trend and funding pressures, and the need to support margin recovery, we have made significant adjustments to benefits," he said. What are Medicare Advantage plans? Big picture view According to KFF, there are two ways to get Medicare, the government's health coverage program mostly for people ages 65 and over. Standard Medicare includes hospital and medical insurance that covers a share of medical expenses after you meet a deductible. You can join a separate Medicare drug plan for prescription drug coverage. RELATED: These states are spending the most on health insurance, study shows You can also opt for Medicare Advantage, a private health insurance plan approved by Medicare that includes hospital, medical and usually prescription drug coverage, in addition to other benefits that standard Medicare doesn't cover. By the numbers In 2024, 54%f of eligible Medicare beneficiaries – 32.8 million people out of 61.2 million – were enrolled in Medicare Advantage plans. That's up from 19% in 2007, according to KFF. The Congressional Budget Office projects that by 2034, 64% of people enrolled in Medicare will have Medicare Advantage plans. UnitedHealth under federal investigation Dig deeper The decision to drop some plans comes as UnitedHealthcare faces a federal civil fraud investigation into how it records diagnoses that lead to extra payments for its Medicare Advantage plans, according to The Wall Street Journal. RELATED: Rural hospitals prepare for financial hits, potential closures under GOP's $1 trillion Medicaid cut The paper has since said a federal criminal health care-fraud unit was investigating how the company used doctors and nurses to gather diagnoses that bolster payments. UnitedHealth said in the filing Thursday that it "has full confidence in its practices and is committed to working cooperatively with the Department throughout this process." The nation's third-largest company The backstory UnitedHealth Group Inc. runs one of the nation's largest health insurance and pharmacy benefits management businesses. It also operates a growing Optum business that provides care and technology support. UnitedHealth raked in more than $400 billion in revenue last year to come in third in the Fortune 500 list of biggest U.S. companies. Its share price topped $630 last fall to reach a new all-time high. But the stock has mostly shed value since December, when UnitedHealthcare CEO Brian Thompson was fatally shot in midtown Manhattan on his way to the company's annual investor meeting. A suspect, Luigi Mangione, has been charged in connection with the shooting. In April, shares plunged some more after the company cut its forecast due to a spike in health care use. A month later, former CEO Andrew Witty resigned, and the company withdrew its forecast entirely, saying that medical costs from new Medicare Advantage members were higher than expected. UnitedHealth's stock price was down more than 5% on Aug. 6, to $245.78. The Source This report includes information from UnitedHealth Group, The Wall Street Journal, KFF, The Spokesman-Review, The Associated Press and previous LiveNow from FOX reporting. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Wales Online
04-08-2025
- Wales Online
Investigation launched after man dies at Welsh prison
Investigation launched after man dies at Welsh prison It is the fourth death at the prison this year being examined HMP Berwyn is one of the biggest jails in Europe (Image:) An investigation has been launched after the death of a man at a Welsh prison. Prisoner Darren Watts, who was 51, died last month at HMP Berwyn in Wrexham. The Prisons and Probation Ombudsman (PPO) has confirmed it is examining the circumstances surrounding his death, which happened on Sunday, July 13. It is the fourth inquiry launched by the PPO in 2025 following the death of a prisoner at HMP Berwyn. For our free daily briefing on the biggest issues facing the nation, sign up to the Wales Matters newsletter here . A spokesperson for the PPO said: "We can only investigate issues that may be related to someone's death. This could include how their physical or mental health, suicide, self-harm and substance misuse risks have been managed." Darren Watts was born on November 3, 1973. As an inmate at a category C prison that can accommodate up to 2,100 men, the PPO will assess his post-mortem report and speak to prison staff before reaching its conclusions. The investigation will also consider clinical reviews, records of interviews and other relevant documents. Article continues below A PPO report will be sent to the bereaved family before a final version is issued. A coroner will then conduct an inquest to establish how he died. A Prison Service spokesperson said: "Our thoughts remain with the friends and family of Darren Watts. As with all deaths in custody, the Prisons and Probation Ombudsman will investigate." Join our WhatsApp news community here for the latest breaking news.
New Paper
29-07-2025
- New Paper
Jail for man who violated PPO 12 times, assaulted elderly parents
A man who attacked his elderly parents after quarrelling over financial matters, even as he violated a Personal Protection Order (PPO) 12 times, was sentenced to 14 weeks in prison on July 25. Zhuo Chunsheng (transliteration), 47, faced two charges of voluntarily causing hurt and two charges of violating the Women's Charter. He was sentenced after pleading guilty to two of the charges, according to Shin Min Daily News. Slapped father, pulled mother's hair At around 2pm on January 23, Zhuo asked his father for $500 to open a new bank account, but the 74-year-old said that he had no money. In the ensuing quarrel, Zhuo slapped the elderly man. He received a stern warning after his father called the police. On May 10, the defendant was alone at home with his 73-year-old mother when they got into an argument because his mother had given CDC vouchers to his brother. In a fit of rage, he pulled his mother's hair and threw her mobile phone to the ground. When she tried to leave her flat, Zhuo prevented her from doing so as he was worried that she would call the police. She then sought help from passers-by who were handing out flyers. Upon seeing this, Zhuo took his mother's mobile phone and ran away. He was arrested early the next morning and has been remanded in custody ever since. I have forgiven him: Mother The prosecution told the court that Zhuo had a long criminal record, mostly comprising crimes of domestic violence against his parents. He also breached the PPO obtained by his parents 12 times. Therefore, he should be severely punished to achieve a deterrent effect. Zhuo, who was not represented by a lawyer, pleaded for leniency as he feared a reformative detention sentence or being locked up in a mental health institute for life. "I promise not to offend again. If I do, I will have nothing to say if you send me to reformative detention." Zhuo's mother also spoke in court, saying that she had forgiven him. She added that her son had diabetes and needed insulin. She feared that his condition would worsen and he might even have to undergo amputation. When sentencing Zhuo, the judge said that as a son, his responsibility was to take care of and love his parents, not to hurt them. The judge reminded Zhuo to remember what he had said in court, and expressed hopes that he would accept and cooperate with the rehabilitation plan arranged by the authorities.
Economic Times
24-07-2025
- Business
- Economic Times
New Delhi opens govt procurement to UK companies
Representational For the first time, India will open approximately 40,000 high-value contracts from central ministries and departments in sectors such as transport, green energy and infrastructure to UK bidders. UK-origin goods with just 20% domestic content will be treated as 'Class II' local suppliers under India's Public Procurement Order (PPO), a classification previously reserved for Indian suppliers with 20-50% local content under the CETA. India will offer concessions in government procurement to UK firms under the free trade agreement, a move experts see as a strategic shift away from using public procurement as a tool for domestic industrial development. After the UAE, India has opened its central government procurement for British companies, subject to certain conditions. "The GP chapter provides a legal guarantee for Indian suppliers to be treated on par with UK suppliers regarding social value considerations within procurement processes, ensuring a level playing field for Indian businesses to compete fairly," said an official.
Time of India
24-07-2025
- Business
- Time of India
New Delhi opens govt procurement to UK companies
For the first time, India will open approximately 40,000 high-value contracts from central ministries and departments in sectors such as transport, green energy and infrastructure to UK bidders. UK-origin goods with just 20% domestic content will be treated as 'Class II' local suppliers under India's Public Procurement Order (PPO), a classification previously reserved for Indian suppliers with 20-50% local content under the CETA. India will offer concessions in government procurement to UK firms under the free trade agreement , a move experts see as a strategic shift away from using public procurement as a tool for domestic industrial development. After the UAE, India has opened its central government procurement for British companies, subject to certain conditions. "The GP chapter provides a legal guarantee for Indian suppliers to be treated on par with UK suppliers regarding social value considerations within procurement processes, ensuring a level playing field for Indian businesses to compete fairly," said an official.
