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Trump admin secures pledge from 75% of health insurers in bid to improve patient care

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Trump admin secures pledge from 75% of health insurers in bid to improve patient care

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Roughly three-quarters of the nation’s health insurance providers signed a series of commitments this week in an effort to improve patient care by reducing bureaucratic hurdles caused by insurance companies’ prior-authorization requirements.

Director of the Centers for Medicare and Medicaid Services, Dr. Mehmet Oz, alongside Health and Human Services Secretary, Robert F. Kennedy Jr., announced the new voluntary pledge from a cadre of insurance providers, who cover roughly 75% of the population, during a press conference Monday. The new commitments are aimed at speeding up and reducing prior-authorization processes used by insurers, a process that has been long-maligned for unnecessarily delaying patient care and other bureaucratic hurdles negatively impacting patients.   

“The pledge is not a mandate. It’s not a bill, a rule. This is not legislated. This is a opportunity for industry to show itself,” Oz said Monday. “But by the fact that three-quarters of the patients in the country are already covered by participants in this pledge, it’s a good start and the response has been overwhelming.”

A NEW LAW IN THIS STATE BANS AUTOMATED INSURANCE CLAIM DENIALS

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Health insurance companies representing roughly 75% of patients in the U.S. signed an industry-led pledge this week aimed at improving patient care through streamlining the long-maligned prior-authorization process used by insurance companies to ensure patients are receiving appropriate care. (Getty Images; AP; iStock)

Prior-authorization is a process that requires providers to obtain approval from a patient’s insurance provider before that provider can offer certain treatments or services. Essentially, the process seeks to ensure patients are getting the right solution for a particular problem.

However, according to Oz, the process has led to doctors being forced to spend enormous amounts of man-power to satisfy prior-authorization requirements from insurers. He noted during Monday’s press conference that, on average, physicians have to spend 12 hours a week dealing with these requirements, which they see about 40 of per week. 

“It frustrates doctors. It sometimes results in care that is significantly delayed. It erodes public trust in the healthcare system. It’s something we can’t tolerate,” Oz insisted.

DR. OZ SAYS TAXPAYERS FOOTING $14 BILLION BILL FOR MEDICAID FRAUD WHILE ELIGIBLE PATIENTS STRUGGLE FOR CARE 

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Dr. Mehmet Oz, the director of the Centers for Medicare and Medicaid Services, said during a press conference Monday announcing the new industry-led pledge, that the new commitments will significantly improve patient access to care.  (Anna Moneymaker/Getty Images)

The pledge has been adopted by some of the nation’s largest insurance providers, including United Healthcare, Cigna, Humana, Blue Cross & Blue Shield, Aetna and many more. While the industry-led commitments aim to improve care for patients, it could potentially eat into their profits as well if patients start seeking care more often.

The commitments from insurers cemented this week include taking active steps to implement a common standardized process for electronic prior-authorization through the development of standardized submission requirements to support faster turnaround time. The goal is for the new framework to be operational by Jan. 1, 2027.

Another part of the pledge includes a commitment from individual insurance plans to implement certain reductions in its use of medical prior-authorization by Jan. 1, 2026. On that date, if patients switch insurance providers during the course of treatment, their new plan must honor their existing prior-authorization approvals for 90-days while the patient transitions.

DR. OZ UNPACKS POSSIBLE WORK REQUIREMENTS FOR MEDICAID

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Prior-authorization is a long-criticized process that critics have argued blocks patients’ access to care. (iStock)

Transparency is also a key part of the new commitments from insurance providers. Health plans enjoined with the commitments will pledge to provide clear and easy-to-understand explanations of prior-authorization determinations, including guidance for appeals. The commitment also states that by 2027, 80% of electronic prior-authorization approvals from companies will be answered in real-time.   

Oz, during the Monday press conference, compared the industry-led pledge to the Bible, saying, “The meek shall inherit the earth.”

“I always grew up thinking ‘meek’ meant weak, but that’s not what meek means. ‘Meek’ means you have a sharp sword, a sword that could do real damage to people around you, but you decide, electively, to sheathe that sword and put it away for a while, so you can do goods, so you can do important things where once in a while we have to get together, even if we’re competitors, and agree,” Oz said Monday.

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“That’s what these insurance companies and hospital systems have done,” he continued. “They have agreed to sheathe their swords to be meek for a while, to come up with a better solution to a problem that plagues us all.”

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FBI Director Kash Patel says bureau ramping up AI to counter domestic, global threats

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FBI Director Kash Patel says bureau ramping up AI to counter domestic, global threats

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FBI Director Kash Patel said Saturday that the agency is ramping up its use of artificial intelligence (AI) tools to counter domestic and international threats.

In a post on X, Patel said the FBI has been advancing its technology, calling AI a “key component” of its strategy to respond to threats and stay “ahead of the game.”

“FBI has been working on key technology advances to keep us ahead of the game and respond to an always changing threat environment both domestically and on the world stage,” Patel wrote. “Artificial intelligence is a key component of this.”

‘PEOPLE WOULD HAVE DIED’: INSIDE THE FBI’S HALLOWEEN TAKEDOWN THAT EXPOSED A GLOBAL TERROR NETWORK

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Kash Patel, director of the FBI, speaks during a news conference at the Department of Justice in Washington, D.C. ( Eric Lee/Bloomberg via Getty Images)

Patel said the bureau is developing an AI initiative aimed at supporting investigators and analysts working in the national security space.

“We’ve been working on an AI project to assist our investigators and analysts in the national security space — staying ahead of bad actors and adversaries who seek to do us harm,” he said.

Patel added that FBI leadership has established a “technology working group” led by outgoing Deputy Director Dan Bongino to ensure the agency’s tools “evolve with the mission.”

EXCLUSIVE: FBI CONCLUDES TRUMP SHOOTER THOMAS CROOKS ACTED ALONE AFTER UNPRECEDENTED GLOBAL INVESTIGATION

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The bureau is ramping up its use of AI tools to counter domestic and international threats. (Brendan Smialowski/AFP )

“These are investments that will pay dividends for America’s national security for decades to come,” Patel said.

A spokesperson for the FBI told Fox News Digital it had nothing further to add beyond Patel’s X post.

The FBI currently uses AI for tools such as vehicle recognition, voice-language identification, speech-to-text analysis and video analytics, according to the agency’s website.

DAN BONGINO TO RESIGN FROM FBI DEPUTY DIRECTOR ROLE IN JANUARY

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Patel credited outgoing Deputy Director Dan Bongino for his leadership with the AI initiative. (Michael M. Santiago/Getty Images)

Earlier this week, Bongino announced he would leave the bureau in January after speculation rose concerning his departure.

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“I will be leaving my position with the FBI in January,” Bongino wrote in an X post Wednesday. “I want to thank President [Donald] Trump, AG [Pam] Bondi, and Director Patel for the opportunity to serve with purpose. Most importantly, I want to thank you, my fellow Americans, for the privilege to serve you. God bless America, and all those who defend Her.”

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Lawmakers weigh impeachment articles for Bondi over Epstein file omissions

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Lawmakers weigh impeachment articles for Bondi over Epstein file omissions

Lawmakers unhappy with Justice Department decisions to heavily redact or withhold documents from a legally mandated release of files related to Jeffrey Epstein threatened Saturday to launch impeachment proceedings against those responsible, including Pam Bondi, the U.S. attorney general.

Democrats and Republicans alike criticized the omissions, while Democrats also accused the Justice Department of intentionally scrubbing the release of at least one image of President Trump, with Senate Minority Leader Chuck Schumer (D-N.Y.) suggesting it could portend “one of the biggest coverups in American history.”

Trump administration officials have said the release fully complied with the law, and that its redactions were crafted only to protect victims of Epstein, a disgraced financier and convicted sex offender accused of abusing hundreds of women and girls before his death in 2019.

Rep. Ro Khanna (D-Fremont), an author of the Epstein Files Transparency Act, which required the release of the investigative trove, blasted Bondi in a social media video, accusing her of denying the existence of many of the records for months, only to push out “an incomplete release with too many redactions” in response to — and in violation of — the new law.

Khanna said he and the bill’s co-sponsor, Rep. Thomas Massie (R-Ky.), were “exploring all options” for responding and forcing more disclosures, including by pursuing “the impeachment of people at Justice,” asking courts to hold officials blocking the release in contempt, and “referring for prosecution those who are obstructing justice.”

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“We will work with the survivors to demand the full release of these files,” Khanna said.

He later added in a CNN interview that he and Massie were drafting articles of impeachment against Bondi, though they had not decided whether to bring them forward.

Massie, in his own social media post, said Khanna was correct in rejecting the Friday release as insufficient, saying that it “grossly fails to comply with both the spirit and the letter of the law.”

The lawmakers’ view that the Justice Department’s document dump failed to comply with the law echoed similar complaints across the political spectrum Saturday, as the full scope of redactions and other withholdings came into focus.

The frustration had already sharply escalated late Friday, after Fox News Digital reported that the names and identifiers of not just victims but of “politically exposed individuals and government officials” had been redacted from the records — which would violate the law, and which Justice Department officials denied.

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Among the critics was Rep. Marjorie Taylor Greene (R-Ga.), who cited the Fox reporting in an exasperated post late Friday to X.

“The whole point was NOT to protect the ‘politically exposed individuals and government officials.’ That’s exactly what MAGA has always wanted, that’s what drain the swamp actually means. It means expose them all, the rich powerful elites who are corrupt and commit crimes, NOT redact their names and protect them,” Greene wrote.

Senior Justice Department officials later called in to Fox News to dispute the report. But the removal of a file published in the Friday evening release, capturing a desk in Epstein’s home with a drawer filled of photos of Trump, reinforced bipartisan concerns that references to the president had been illegally withheld.

In a release of documents from the Epstein family estate by the House Oversight Committee this fall, Trump’s name was featured over 1,000 times — more than any other public figure.

“If they’re taking this down, just imagine how much more they’re trying to hide,” Schumer wrote on X. “This could be one of the biggest coverups in American history.”

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Several victims also said the release was insufficient. “It’s really kind of another slap in the face,” Alicia Arden, who went to the police to report that Epstein had abused her in 1997, told CNN. “I wanted all the files to come out, like they said that they were going to.”

Trump, who signed the act into law after having worked to block it from getting a vote, was conspicuously quiet on the matter. In a long speech in North Carolina on Friday night, he did not mention it.

However, White House officials and Justice Department leaders rejected the notion that the release was incomplete or out of compliance with the law, or that the names of politicians had been redacted.

“The only redactions being applied to the documents are those required by law — full stop,” said Deputy Atty. Gen. Todd Blanche. “Consistent with the statute and applicable laws, we are not redacting the names of individuals or politicians unless they are a victim.”

Other Republicans defended the administration. Rep. James Comer (R-Ky.), chair of the House Oversight Committee, said the administration “is delivering unprecedented transparency in the Epstein case and will continue releasing documents.”

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Epstein died in a Manhattan jail awaiting trial on sex trafficking charges. He’d been convicted in 2008 of procuring a child for prostitution in Florida, but served only 13 months in custody in what many condemned as a sweetheart plea deal for a well-connected and rich defendant.

Epstein’s acts of abuse have attracted massive attention, including among many within Trump’s political base, in part because of unanswered questions surrounding which of his many powerful friends may have also been implicated in crimes against children. Some of those questions have swirled around Trump, who was friends with Epstein for years before the two had what the president has described as a falling out.

Evidence has emerged in recent months that suggests Trump may have had knowledge of Epstein’s crimes during their friendship.

Epstein wrote in a 2019 email, released by the House Oversight Committee, that Trump “knew about the girls.” In a 2011 email to Ghislaine Maxwell, who was convicted of conspiring with Epstein to help him sexually abuse girls, Epstein wrote that “the dog that hasn’t barked is trump. [Victim] spent hours at my house with him … he has never once been mentioned.”

Trump has denied any wrongdoing.

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The records released Friday contained few if any major new revelations, but did include a complaint against Epstein filed with the FBI back in 1996 — which the FBI did little with, substantiating long-standing fears among Epstein’s victims that his crimes could have been stopped years earlier.

Sen. Adam Schiff (D-Calif.), one of the president’s most consistent critics, wrote on X that Bondi should appear before the Senate Judiciary Committee to explain under oath the extensive redactions and omissions, which he called a “willful violation of the law.”

“The Trump Justice Department has had months to keep their promise to release all of the Epstein Files,” Schiff wrote. “Epstein’s survivors and the American people need answers now.”

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Sen Murphy warns ‘people are going to die’ as Congress punts on expiring Obamacare subsidies

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Sen Murphy warns ‘people are going to die’ as Congress punts on expiring Obamacare subsidies

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A bipartisan Obamacare fix remains out of reach in the Senate, for now, and lawmakers can’t agree on who is at fault. 

While many agree that the forthcoming healthcare cliff will cause financial pain, the partisan divide quickly devolved into pointing the finger across the aisle at who owns the looming healthcare premium spikes that Americans who use the healthcare exchange will face. 

Part of the finger-pointing has yielded another surprising agreement: Lawmakers don’t see the fast-approaching expiration of the Biden-era enhanced Obamacare subsidies as Congress failing to act in time.

“Obviously, it’s not a failure of Congress to act,” Sen. Chris Murphy, D-Conn., told Fox News Digital. “It’s a failure of Republicans to act. Democrats are united and wanting to expand subsidies. Republicans want premium increases to go up.”

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Partisan rancor over Obamacare has seeped into how lawmakers view the effect that expiring subsidies will have on their constituents. Sen. Chris Murphy, D-Conn., argued that it was a “life or death” situation, while Republicans contended that Democrats set up the very cliff they maligned.  (Tom Williams/CQ-Roll Call, Inc. via Getty Images)

DEMOCRATS’ LAST-MINUTE MOVE TO BLOCK GOP FUNDING PLAN SENDS LAWMAKERS HOME EARLY

Senate Republicans and Democrats both tried, and failed, to advance their own partisan plans to replace or extend the subsidies earlier this month. And since then, no action has been taken to deal with the fast-approaching issue, guaranteeing that the subsidies will lapse at the end of the year.

A report published last month by Kaiser Family Foundation, a nonprofit healthcare think tank, found that Americans who use the credits will see an average increase of 114% in their premium costs.

The increase can vary depending on how high above the poverty level a person is. The original premium subsidies set a cap at 400% above the poverty level, while the enhanced subsidies, which were passed during the COVID-19 pandemic, torched the cap.

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For example, a person 60 years or older making 401% of the poverty level, or about $62,000 per year, would on average see their premium prices double. That number can skyrocket depending on the state. Wyoming clocks in at the highest spike at 421%.

SENATE MULLS NEXT STEPS AFTER DUELING OBAMACARE FIXES GO UP IN FLAMES

Sen. Rick Scott, R-Fla., doesn’t want to blow up Obamacare or get rid of Obamacare subsidies, but he does want to provide Americans with more options for healthcare.  (Andrew Harnik/Getty Images)

In Murphy’s home state of Connecticut, premiums under the same parameters would hike in price by 316%.

“When these do lapse, people are going to die,” Murphy said. “I mean, I was talking to a couple a few months ago who have two parents, both with chronic, potentially life-threatening illnesses, and they will only be able to afford insurance for one of them. So they’re talking about which parent is going to survive to raise their three kids. The stakes are life and death.”

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Both sides hold opposing views on the solution. Senate Republicans argue that the credits effectively subsidize insurance companies, not patients, by funneling money directly to them, and that the program is rife with fraud.

Senate Democrats want to extend the subsidies as they are, and are willing to negotiate fixes down the line. But for the GOP, they want to see some immediate reforms, like income caps, anti-fraud measures and more stringent anti-abortion language tied to the subsidies.

Sen. Rick Scott, R-Fla., who produced his own healthcare plan that would convert subsidies into health savings accounts (HSAs), argued that congressional Democrats “set this up to expire.”

SENATE REPUBLICANS LAND ON OBAMACARE FIX, TEE UP DUELING VOTE WITH DEMS

Senate Majority Leader John Thune, R-S.D., panned Senate Democrats’ Obamacare subsidy proposal as “obviously designed to fail.”  (Tom Williams/CQ-Roll Call, Inc. via Getty Images)

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But he doesn’t share the view that the subsidies’ expected expiration is a life-or-death situation.

“I’m not taxing somebody who makes 20 bucks an hour to pay for healthcare for somebody who makes half a million dollars a year, that’s what they did,” he told Fox News Digital. “All they did was mask the increase in healthcare costs. That’s all they did with it.”

Sen. Jim Banks, R-Ind., similarly scoffed at the notion, and told Fox News Digital, “The Democrat plan to extend COVID-era Obamacare subsidies might help less than half a percent of the American population.”

“The Republican plan brings down healthcare costs for 100% of Americans,” he said. “More competition, expands health savings accounts. That needs to be the focus.”

Democrats are also not hiding their disdain for the partisan divide between their approaches to healthcare.

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Sen. Brian Schatz, D-Hawaii, told Fox News Digital that the idea that this “is a congressional failure and not a Republican policy is preposterous.”

“They’ve hated the Affordable Care Act since its inception and tried to repeal it at every possible opportunity,” he said, referring to Obamacare. “The president hates ACA, speaker hates ACA, majority leader hates ACA, rank-and-file hate ACA. And so this is not some failure of bipartisanship.”

While the partisan rancor runs deep on the matter of Obamacare, there are Republicans and Democrats working together to build a new plan. Still, it wouldn’t deal with the rapidly approaching Dec. 31 deadline to extend the subsidies.

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Senate Majority Leader John Thune, R-S.D., predicted that the Senate would have a long road to travel before a bipartisan plan came together in the new year, but he didn’t rule it out.

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“It’s the Christmas season. It would take a Christmas miracle to execute on actually getting something done there,” he said. “But, you know, I think there’s a potential path, but it’ll be heavy lift.”

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