CATEGORIES

Policy and Practice

LATEST

TRENDING

EDITORS CHOICE

“Investigational” Is Payer Code for “Coverage Denied”

Outside the pandemic, “investigational” remains payer code for denying reimbursement. In the case of treatment for chronic conditions, even FDA-approved digital-health and connected devices languish on waitlists for formulary inclusion.

The Covid Global Clinical Trials for mRNA. Thank You for Participating

There are more than one hundred ways an RNA molecule can be chemically modified after it is synthesized. The functions of many of these...

‘They Won’t Help Me’: Sickest Patients Face Insurance Denials Despite Policy Fixes

In 2023, Sheldon Ekirch was diagnosed with small fiber neuropathy, which makes her limbs and muscles feel as if they’re on fire. Specialists recommended a series of infusions to ease her pain, but her insurer refused to pay for the expensive treatment, which it says is “not considered medically necessary.”

Five Billion People Unprotected from Trans Fat Leading to Heart Disease

Five billion people globally remain unprotected from harmful trans fat, a new status report from WHO has found, increasing their risk of heart disease...