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 AHA filed an amicus brief June 5 in the U.S. District Court for the Eastern District of Pennsylvania in support of a provider seeking to obtain…
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The Centers for Medicare & Medicaid Services has released an updated report on complaint data and enforcement of health insurance market reforms. CMS said…
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The House Education and Workforce Committee May 21 unanimously passed the Transparency in Billing Act (H.R. 8684). The bill would require off-campus hospital…
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A KFF analysis published May 19 examined early indicators of how the expiration of the enhanced premium tax credits has impacted effectuated enrollment levels…
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The Centers for Medicare & Medicaid Services May 15 released its 2027 final standards for the health insurance marketplaces, including the issuers and…
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A blog by Noah Isserman, AHA director of health insurance and coverage policy, explains why Anthem’s nonparticipating provider policy limits patients’ …