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It's Not Just Denied Claims. Insurance Firms Are Hiring Middlemen to Deny Meds.


Published on 2024-12-15 08:21:12 - MSN
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  • Amid an outpouring of frustration with for-profit health insurance sparked by the assassination of UnitedHealthcare CEO Brian Thompson on December 4, much of the media coverage has focused on the alleged shooter,

The article from MSN discusses how insurance companies are increasingly employing third-party firms to manage and often deny coverage for medications, particularly those that are expensive or newly introduced. These middlemen, known as pharmacy benefit managers (PBMs), are tasked with reviewing and often rejecting claims for high-cost drugs, which can lead to significant delays or denials in patient care. This practice not only affects patients by limiting access to necessary treatments but also raises concerns about the transparency and ethics of insurance practices. The article highlights cases where patients face hurdles in obtaining medications for conditions like cancer or chronic illnesses, pointing out that these denials can be based on cost-saving measures rather than medical necessity. This has led to criticism from healthcare providers and patient advocacy groups who argue that such practices prioritize profit over patient health.

Read the Full MSN Article at:
[ https://www.msn.com/en-us/money/other/it-s-not-just-denied-claims-insurance-firms-are-hiring-middlemen-to-deny-meds/ar-AA1vTu2F ]