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As artificial intelligence embeds itself into health care, some physicians and patient advocates worry it could be used by insurance companies to refuse payment for care. Maryland passed one law banning AI from acting alone on a denial. Meanwhile, Virginia’s then-governor vetoed that state’s attempt at regulating AI in health insurance.
After Eric Tennant died, his widow vowed to speak out against West Virginia’s Public Employees Insurance Agency, which had denied cancer treatment recommended by Tennant’s doctor. Her efforts paid off. In March, West Virginia’s governor signed a bill to protect some patients from harm tied to prior authorization.
Last summer, the Trump administration announced a voluntary pledge by health insurers to reform prior authorization, which often requires patients or their doctors to seek preapproval from insurers before proceeding with medical care. Patient advocates and medical providers remain skeptical.
A revolt is afoot in both red and blue states against the use of artificial intelligence in health insurance determinations — and against efforts led by President Donald Trump to tie states’ hands.
A proposed abortion ban in South Carolina would have allowed the criminal prosecution of women who obtain the procedure. It’s unlikely to become law, but this bill and other proposals across the country show how some conservative lawmakers are embracing increasingly punitive abortion restrictions.
When a measles outbreak emerged in Spartanburg, South Carolina, in October, health officials announced that most cases were tied to one public charter school, where only 17% of the 605 students enrolled during the 2024-25 academic year provided documentation showing they had received their required vaccinations.
Eric Tennant’s doctors recommended histotripsy, which would target, and potentially destroy, a cancerous tumor in his liver. But by the time his insurer approved the treatment, Tennant was no longer considered a good candidate. He died in September.
A Maine woman sought care at a clinic for a tick bite, then paid full price after her insurer denied coverage. Its reason? She didn't have preapproval for the walk-in visit, even though testing later detected the pathogen that causes Lyme disease.
A pilot program testing the use of artificial intelligence to expand prior authorization decisions in Medicare has providers, politicians, and researchers questioning Trump administration promises to curb an unpopular practice that has frustrated patients and their doctors.
Many people don’t know they can fight a health insurance denial, let alone how to do it. Here are practical tips for consumers who want to appeal a prior authorization decision.
Even as states brace for significant reductions in federal Medicaid funding over the next decade, conservative legislatures across the country are passing laws that grant doula access to Medicaid beneficiaries.
Dozens of health insurance companies pledged on Monday to improve prior authorization, a process often used to deny care. The announcement comes months after the killing of UnitedHealthcare executive Brian Thompson, whose death in December sparked widespread criticism about insurance denials.
Health insurers issue millions of prior authorization denials every year, leaving many patients stuck in a convoluted appeals process, with little hope of meaningful policy change ahead. For doctors, these denials are frustrating and time-consuming. For patients, they can be devastating.
Late last year, South Carolina Medicaid approved a class of medications known as GLP-1s to treat obesity, placing it among the few state programs covering these effective but expensive drugs. But access remains limited, even for patients covered by Medicaid, because of stringent prerequisites that must be satisfied before starting the drug.
Carmen Aiken of Chicago thought their medical appointment would be covered because the Affordable Care Act requires insurers to pay for a long list of preventive services. But after the appointment, Aiken received a bill for more than $1,400.
The fatal shooting of UnitedHealthcare CEO Brian Thompson prompted both grief and public outrage about the ways insurers deny treatment. Republicans and Democrats agree prior authorization needs fixing, but patients are growing impatient.
State legislatures nationwide, including several in the South, are spending millions to improve rural health outcomes and access. For years, though, most Southern states have refused billions of federal dollars to provide public health insurance to more low-income adults. That isn’t likely to change with Trump back in office.
The helicopter evacuation of 70 people from a Tennessee hospital during Hurricane Helene is considered a success story. The building was destroyed by floodwaters, but no one died. In hindsight, why was it built next to a river?
An Alabama teen was told he needed surgery for debilitating hip pain. But his family’s insurer denied coverage for the procedure, which lacked a medical billing code. Expected to pay more than $7,000, his father charged it to credit cards.
Amari Marsh, now 23, was a student at South Carolina State University when she lost her pregnancy in 2023. She was charged with murder and faced at least 20 years in prison. A grand jury cleared her in August. Now she’s sharing her story.
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