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Wednesday, April 22, 2026

'Optum Rx’s prior auth tool cuts prescription approvals from 8 hours to 30 seconds'

 Optum Rx — the pharmacy benefit manager for UnitedHealth Group — claims its “PreCheck” prior authorization tool not only cuts prescription approval times but also reduces denials and appeals.

UnitedHealth Group gave an update on the tool in an April 21 earnings call. Optum CEO Patrick Conway, MD, said denials due to missing information dropped by 68% and appeals were down 88%, thanks to PreCheck. He said PreCheck has been “easing interactions for clients, members and providers.”

Dr. Conway reaffirmed that PreCheck has axed prescription approval time from eight hours to fewer than 30 seconds. 

Optum Rx announced an expansion of PreCheck in November, alongside its decision to eliminate reauthorization requirements for 40 medications. In the November release, UnitedHealth Group said, as of this year, the PreCheck platform covers more than 45 medications and is leveraged across 20 health systems.

Insurers have been rolling back prior authorizations since an industrywide pledge last summer, which included UnitedHealthcare. The insurer’s stated goal is to cut prior authorizations by at least 30% by the end of 2026.

Additionally, Optum Rx onboarded more than 800 clients but lowered call center volume by one-quarter through elevated digital and AI-enabled self-service. Member satisfaction surpassed 95%, according to Dr. Conway.

This year, UnitedHealth committed to a $1.5 billion AI spend as it continues to explore use cases, particularly as the tech-enabled services business Optum Insight transitions to an AI-first model.

https://www.beckershospitalreview.com/pharmacy/optum-rxs-prior-auth-tool-cuts-prescription-approvals-from-8-hours-to-30-seconds/

3rd player enters the AI arms race between payers and health systems

 A new class of contenders is entering the AI arms race between payers and health systems.

Several AI startups are now using large language models to fight insurance denials on behalf of patients with early results that are turning heads.

Claimable — founded by British physician and entrepreneur Warris Bokhari, MD, in 2023 — uses an AI model trained on insurance law, medical literature and legal precedents to generate and file appeal letters on behalf of patients. For $50, users submit their case details on the company’s website. Claimable sends the resulting letter to the insurer’s appeals department and, in some cases, to executives, politicians and journalists to add pressure, Bloomberg reported April 22.

About 4,000 patients have used the platform, with about 3 in 4 seeing their denials reversed. In one case, a denial was overturned within a day after Claimable escalated it to the patient’s senator, governor, the insurer’s CEO and investor Mark Cuban, who emailed the employer’s CEO and posted publicly about the situation on LinkedIn.

Claimable is also moving beyond the direct-to-consumer model. The company has signed deals with four drugmakers and is negotiating with health systems to handle appeals on behalf of their patients who have had treatments denied. In addition, the company is exploring a litigation arm to pursue class-action lawsuits when it identifies patterns of allegedly wrongful denials across payers.

Sheer Health, another startup, takes a broader approach, handling the entire appeals process on behalf of patients for $40 a month or a percentage of money recovered, according to CBS News. Users submit their bill via photo upload and the company manages all insurer communication and paperwork.

“Our goal is for people to never have to deal with their health insurance again,” co-founder Ben Howard told the publication.

The startups are entering a market shaped by years of escalating friction between payers and hospital revenue cycle teams over claims and prior authorization. AI is accelerating that dynamic on both sides. As automation makes it faster and easier to deny claims, it is also making it faster and easier to fight them. 

Whether patient-facing tools like Claimable and Sheer Health can meaningfully shift that balance remains to be seen, but the gap they are targeting is real. Claimable estimates insurers deny 850 million claims annually, extrapolated from federal data, though the company did not disclose which dataset or how the figure was calculated. Consumers appealed fewer than 1% of denied claims in 2023, and when they did, insurers upheld their original decision 56% of the time, KFF data shows. 

Lawmakers are also starting to take notice. Arizona passed a law that takes effect this June requiring licensed medical providers to have the final say on coverage denials, and Louisiana is advancing similar legislation that would require human clinical review before any denial is issued.

https://www.beckershospitalreview.com/finance/revenue-cycle-management/a-third-player-enters-the-ai-arms-race/

AMA urges federal oversight of AI chatbots

 The American Medical Association is calling on federal lawmakers to enact safeguards on AI chatbots, particularly when it comes to protecting patients’ mental health.

With the rapid rise of people using chatbots for behavioral and other health-related issues, the AMA wrote April 22 to the co-chairs of the Congressional AI and Digital Health caucuses and the Senate AI Caucus, urging stronger regulation of the technology.

“AI-enabled tools may help expand access to mental health resources and support innovation in healthcare delivery, but they lack consistent safeguards against serious risks, including emotional dependency, misinformation, and inadequate crisis response,” AMA CEO John Whyte, MD, stated in a news release. “With thoughtful oversight and accountability, policymakers can support innovation and ensure technologies prioritize patient safety, strengthen public trust, and responsibly complement — not replace — clinical care.”

The AMA’s recommendations include requiring chatbots to clearly disclose that users are interacting with AI, prohibiting them from presenting themselves as licensed clinicians, banning them from diagnosing or treating mental health conditions without regulatory due diligence, clarifying when AI solutions qualify as medical devices, and mandating strict data protection standards.

https://www.beckershospitalreview.com/healthcare-information-technology/innovation/ama-urges-federal-oversight-of-ai-chatbots/

'CDC blocks COVID-19 vaccine report: Washington Post'

 A CDC report on COVID-19 vaccine effectiveness that the agency delayed in March has now been blocked from publication entirely, The Washington Post reported April 22.

The report found the vaccine reduced the likelihood of emergency department visits and hospital admissions for COVID-19 by about half this past winter among healthy adults.

It was slated for publication March 19 in the CDC’s Morbidity and Mortality Weekly Report but was delayed after National Institutes of Health Director Jay Bhattacharya, MD, PhD, expressed concerns over its methodology. Dr. Bhattacharya has been temporarily leading the agency until a permanent director is named.

“The MMWR’s editorial assessment identified concerns regarding the methodological approach to estimating vaccine effectiveness and the manuscript was not accepted for publication,” an HHS spokesperson told the Post.

The methodology Dr. Bhattacharya flagged has long been used by the CDC to assess vaccine effectiveness for respiratory viruses, including in a flu vaccine effectiveness study the CDC published in March, according to the report.

The report had cleared the CDC’s full internal scientific review process before being stopped, two sources who wished to remain anonymous told the Post. Former CDC officials said the move breaks with longstanding agency practice.

The decision comes as HHS Secretary Robert F. Kennedy Jr. faces congressional scrutiny over his vaccine agenda during budget hearings this month. 

https://www.beckershospitalreview.com/quality/public-health/cdc-blocks-covid-19-vaccine-report-washington-post/

US military intercepts Iranian oil tankers

 The US military intercepted at least three Iranian oil tankers in Asian waters

https://cryptobriefing.com/us-military-intercepts-iranian-oil-tankers-escalating-strait-of-hormuz-crisis/

Kinder Morgan Q1 2026 EPS and revenue beat forecasts, 2026 EPS guidance of $1.36 per share

 

Kinder Morgan Q1 2026 EPS and revenue beat forecasts and company issues 2026 EPS guidance of $1.36 per share

  • Q1 2026 net income increased 36% year over year to $976 million.
  • Reported Q1 EPS $0.44, with adjusted EPS of $0.48 for the quarter.
  • 2026 earnings are tracking over 3% above budget for 2026.
  • Latest SEC filing discloses a $505 million acquisition of the Monument pipeline.
  • The same SEC filing outlines a planned COO succession at Kinder Morgan.
  • Quarterly dividend raised 2% to $0.2975 per share following Q1 2026 earnings results.

'Alligator Alcatraz' Can Continue Operating, Appeals Court Says

 by Troy Myers via The Epoch Times,

A federal appeals court on Tuesday pulled a judge’s previous order to dismantle the high-profile detention center in the Florida Everglades for illegal immigrants, known as “Alligator Alcatraz.”

In a 2–1 ruling, the U.S. Court of Appeals for the 11th Circuit sided with the Trump administration’s argument that there was minimal federal involvement in the facility’s construction, so a federal environmental review was not warranted.

“Using state employees and state funds, Florida officials, on their own initiative, constructed a detention center at an airport on state property in the Florida Everglades,” court documents showed.

Two environmental groups, Friends of the Everglades and the Center for Biological Diversity, joined the Miccosukee Tribe, which has villages close to the facility, in challenging construction of Alligator Alcatraz.

The groups accused state and federal officials of rushing to build the facility and failing to conduct an environmental review as required under the National Environmental Policy Act.

That federal law, passed in 1970, requires federal agencies to evaluate environmental impacts of proposed major construction.

Construction began last year on the facility, located at the Dade-Collier Training and Transition Airport in the Everglades, to assist with the Trump administration’s immigration enforcement and detainment of illegal aliens.

A lower court in August sided with the environmental groups and the Miccosukee Tribe, ordering officials to halt construction and even undo some work that had already been finished. But the higher court’s Tuesday order lifted that.

Federal authorities inspected the site for compliance with federal standards, court documents said, but this wasn’t enough to trigger a federally mandated environmental review.

“Because the environmentalists and Tribe failed to prove either a final agency action or federal control, and because the injunction, in part, violates a statutory prohibition of enjoining immigration enforcement, we vacate and remand,” Chief Judge William Pryor wrote in the federal appeals court ruling.

The 11th circuit has now twice lifted orders to halt construction—Tuesday’s ruling and again back in September.

“Victory secured against activist judge who held me in contempt,” Florida’s Attorney General James Uthmeier wrote on X in response to the 11th circuit’s September decision.

“A win for Florida and President [Donald] Trump’s agenda!”

Friends of the Everglades and the Miccosukee Tribe did not immediately respond to a request for comment.

The Center for Biological Diversity, however, issued a news release Tuesday in response to the latest legal development, calling it a “temporary” setback.

Wildlife and ecosystems remain imperiled, the group said.

“This disappointing decision won’t stop our challenges to the numerous environmental violations that the Trump administration is overseeing there,” Elise Bennett, director and senior attorney at the Center for Biological Diversity, said. “We’ll keep fighting because the Trump and DeSantis administrations’ obsession with sacrificing our Everglades, endangered panthers and wild waters to their cruel detention center is utterly indefensible.”

The groups further argue there was enough federal involvement to warrant a federal environmental review. The Center for Biological Diversity said FEMA committed hundreds of millions of dollars to Florida for building and operating the facility.

Eve Samples, executive director of Friends of the Everglades, had a statement in the news release as well, saying, “This fight is far from over.”

“Alligator Alcatraz was hastily erected in one of the most fragile ecosystems in the country without the most basic environmental review, at immense human and ecological cost,” she said.

Samples added that she is pursuing every legal avenue available to shut down Alligator Alcatraz.

https://www.zerohedge.com/political/alligator-alcatraz-can-continue-operating-appeals-court-says