RISE summarizes recent regulatory-related headlines and reports.
UnitedHealth to exit some MA plans in 2026
UnitedHealth will eliminate Medicare Advantage plans that cover approximately 600,000 members, according to NewsNation. The company is the largest insurer of Medicare Advantage plans in the United States. Tim Noel, who serves as CEO of UnitedHealth Group’s health insurance division, announced the decision this week during a second-quarter earnings call. NewsNation reports that the exits would affect members in less managed products, such as PPO offerings.
Senate confirms Susan Monarez as the new CDC director
The Centers for Disease Control and Prevention (CDC) finally has a new leader. After four months without a director, the Senate on Tuesday confirmed Susan Monarez, Ph.D., as its new director by a 51-47 vote, which was primarily along party lines.
Monarez most recently served as the deputy director of the Advanced Research Projects Agency for Health (ARPA-H), according to her bio on the CDC website. Prior to her work at the ARPH-H, she led high-impact initiatives focusing on the ethical use of artificial intelligence and machine learning to support improved health outcomes, novel approaches to addressing affordability and accessibility in health care, expanding access to behavioral and mental health interventions, ending the opioid epidemic, addressing health disparities in maternal morbidity and mortality, and improving the country's organ donation and transplantation programs.
She also served at the White House in the Office of Science and Technology Policy and on the National Security Council, leading efforts to enhance the nation's biomedical innovation capabilities, including combating antimicrobial resistance, expanding the use of wearables to promote patient health, ensuring personal health data privacy, and improving pandemic preparedness.
Poll: Prior authorization process difficult to manage
Seventy-three percent of the public thinks that delays and denials of services and treatments by health insurance companies are a major problem, according to the latest KFF Health Tracking Poll, which surveyed 1,283 U.S. adults during the week of July 8-14. Few of the people surveyed were aware of a health care insurance initiative to reduce the burden of prior authorizations for patients. Indeed, only two in 10 adults said they heard a lot or some of this new initiative. Six in 10 said it is unlikely that health insurance companies will follow through on the voluntary initiative in a way that makes a difference to patients.
The poll also found that many feel the process of getting prior authorization is a burden. Among the 51 percent of insured adults who say they have had to get prior authorization in the past two years, many report difficulty navigating the process. Forty-seven percent of those who were required to get a prior authorization in the past two years say it was “somewhat difficult” (34 percent) or “very difficult” (13 percent) to navigate the process of getting prior approval for a health care service, treatment, or needed medication.
HHS offers $100M in pilot funding to eliminate Hepatitis C
The Department of Health and Human Services (HHS) has announced a $100 million pilot funding opportunity to prevent, test for, treat, and cure Hepatitis C—a liver disease caused by the Hepatitis C virus—in individuals with substance use disorder and/or serious mental illness. This program is designed to support communities severely affected by homelessness and to gain insights on effective ways to identify patients, complete treatment, cure infections, and reduce reinfection by Hepatitis C. Untreated Hepatitis C can result in the development of additional chronic diseases, including cirrhosis, liver failure, and liver cancer. The Hepatitis C Elimination Initiative Pilot was developed and will be administered by the Substance Abuse and Mental Health Services Administration.