‘Free’ Screening? Know Your Rights to Get No-Cost Care
Even a decade in, the Affordable Care Act’s recommendations to simply cover preventive screening and care without cost sharing remain confusing and complex.
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How Much Health Insurers Pay for Almost Everything Is About to Go Public
New government rules force health insurers to publicly disclose what they pay for just about every service. That information could help consumers and employers know whether they’re getting a fair deal.
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New Weight Loss Treatment Is Marked by Heavy Marketing and Modest Results
Approved as a device, not a drug, Plenity contains a plant-based gel that swells to fill 25% of a person’s stomach, to help people eat less. Results vary widely but are modest on average.
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As Red Cross Moves to Pricey Blood Treatment Method, Hospitals Call for More Choice
The nation’s largest supplier of platelets is moving to a method it says is easier for hospitals, but one that sharply raises costs, leading some centers to demand more options.
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Sweeping, Limited, or No Powers at All? What’s at Stake in the Mask Mandate Appeal
Dictionaries, public comments, and even an old court case that involved underwear pricing could play a role as the government appeals a ruling that sharply limits federal authority during pandemics.
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Judge’s Ruling on the CDC Mask Mandate Highlights the Limits of the Agency’s Power
A recent court decision that overturns one of the Centers for Disease Control and Prevention’s few pandemic rules — masks required on public transportation — spotlights how little power remains in federal hands to enforce public health protections.
By Sam Whitehead and Julie Appleby -
ACA Sign-Ups for Low-Income People Roll Out Amid Brokers’ Concerns About Losing Their Cut
The Biden administration unveiled a new special enrollment option aimed at signing up low-income Americans for Affordable Care Act coverage — even if it is outside of the usual annual open enrollment period. But insurers are cutting broker commissions at the same time.
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The Case of the $489,000 Air Ambulance Ride
Diagnosed with aggressive leukemia on a Western trip, a young man thought his insurance would cover an air ambulance ride home to North Carolina. Instead, questions about medical necessity left him with an astronomical bill.
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Mental Health Therapists Seek Exemption From Part of Law to Ban Surprise Billing
Some practitioners object to the way upfront cost estimates are designed, saying they could affect access to care and are burdensome. Other experts disagree.
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HHS Proposal for Marketplace Plans Carries a Hefty Dose of Consumer Caution
The Department of Health and Human Services issued preliminary rules regarding health insurance marketplaces that aim to deter fraudulent sign-ups for coverage. Experts say the agency’s action indicates a problem exists.
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How Not to Use Rapid Covid Tests
Although at-home antigen testing remains a useful tool, experts warn it is often used inappropriately and can provide false confidence for people concerned about safety.
By Julie Appleby and Phil Galewitz -
Suit by Doctors, Hospitals Seeks Change in How Arbitrators Settle Surprise Billing Cases
The American Medical Association and American Hospital Association are not arguing to halt the law that protects patients from unexpected bills from providers they didn’t know were outside their insurance network. Instead, they want to change the rules for the mediators who will settle the dispute between insurers and providers.
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Oncology Doctors Say the Build Back Better Act Will Slash Cancer Care Funding — A Skewed Argument
The Community Oncology Alliance is targeting the prescription drug provisions of the Build Back Better Act, saying they will trigger deep cuts in oncologists’ pay, causing clinics to close and health care costs to rise. But it leaves out some important details.
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Post-Pandemic, What’s a Phone Call From Your Physician Worth?
Medicare billing codes for audio-only follow-up check-ins lead to new reimbursement battles.
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New Health Plans Offer Twists on Existing Options, With a Dose of ‘Buyer Beware’
Fueled by consumer frustration with high premiums and deductibles, two new offerings promise a means for consumers to take control of their health care costs. But experts say they pose risks.
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What Do We Really Know About Vaccine Effectiveness?
Reports of waning effectiveness and mixed messages about booster shots fuel the politicization of vaccination.
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Insurance Focused on Virtual Visits? The Pros and Cons of a New Twist in Health Plans
New, often lower-cost plans capitalize on the convenience of telemedicine — and patients’ growing familiarity with it. But consumers should weigh costs and care options before enrolling in a “virtual-first” plan.
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Surprise-Billing Rule ‘Puts a Thumb on the Scale’ to Keep Arbitrated Costs in Check
Patients soon will not have to worry about the prospect of these often-costly unexpected bills, a federal law promises. Some experts say the new policy could also slow the growth of health insurance premiums.
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Biden Releases a New Plan to Combat Covid, but Experts Say There’s Still a Ways to Go
There’s agreement that the plan includes important action items but also elements that will trigger political opposition.
By Victoria Knight and Julie Appleby -
Census: Insured Population Holds Steady, With a Slight Shift From Private to Public Coverage
The Census Bureau on Tuesday released its 2020 findings regarding Americans’ income, poverty and health insurance coverage.
By Victoria Knight and Julie Appleby
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