In today’s newsletter: Videos reveal a key MAGA leader’s plan for a new Trump agenda; how EviCore helps health insurers deny coverage for care; right-wing recruitment of poll workers; and more from our newsroom.
Private videos reveal Trump adviser Russ Vought’s “shadow” plans for using the military on protesters, defunding the EPA and villainizing civil servants.
When health insurance companies want to rein in costs, some turn to EviCore, whose business model depends on turning down payments for care recommended by doctors for their patients. Here are more findings from our investigation:
Dialing for Dollars: America’s largest insurers hire EviCore to make decisions on whether to pay for care for more than 100 million people.
“The Dial”: EviCore uses an algorithm that allows it to adjust the chances that company doctors will screen prior authorization requests, increasing the possibility of denials.
Lucrative Deals: Some EviCore contracts are based on how deeply the company can reduce spending on medical procedures. It tells insurers that it can provide a 3-to-1 return on investment.
EviCore says it scrutinizes requests to make sure that procedures recommended by doctors are safe, necessary and cost-effective, and that the company develops its guidelines with the input of peer-reviewed medical studies and professional societies. It said its decisions are based solely on the guidelines and are not interpreted differently for different clients.
At rallies and revival meetings across the country, activists from the Christian right are urging people, many of whom doubt the 2020 election results, to sign up to work the polls. ProPublica and Wisconsin Watch reporter Phoebe Petrovic went to one event — “a mashup of a Christian tent revival and MAGA rally” — to investigate further. Watch to discover what she found out.
