Banning Noncompete Contracts for Medical Staff Riles Hospitals
It’s about the money — on both sides — as arguments swirl about patient safety, rising prices, and paying back on-the-job training.
Surprise-Billing Law Loophole: When ‘Out of Network’ Doesn’t Quite Mean Out of Network
Billing experts and lawmakers are playing catch-up as providers find ways to get around new surprise-billing laws, leaving patients like Danielle Laskey of Washington state with big bills for emergency care.
A Baby Spent 36 Days in an In-Network NICU. Why Did the Hospital Next Door Send a Bill?
A baby spent more than a month in a Chicago NICU. A big bill revealed she was treated by out-of-network doctors from the children’s hospital next door. Her parents were charged despite a state law protecting patients from such out-of-network billing — and sent to collections when they didn’t pay up.
More Orthopedic Physicians Sell Out to Private Equity Firms, Raising Alarms About Costs and Quality
While some doctors seem eager for a huge payoff, others are warily watching what happens when private equity firms take charge of orthopedic practices.
Hospital Investigated for Allegedly Denying an Emergency Abortion After Patient’s Water Broke
Federal officials have ordered the probe after reports that a woman whose water broke at 18 weeks could not get medical care recommended by her doctors to end the pregnancy because hospital officials were concerned about Missouri’s strict abortion law.
Court Ruling May Spur Competitive Health Plans to Bring Back Copays for Preventive Services
The Affordable Care Act required that health insurers provide many medical screenings and prevention services at no out-of-pocket cost to health plan members. But insurers and employers may consider adding cost sharing for preventive services now that a federal court ruled the ACA’s mandate is unconstitutional.
Patients and Doctors Trapped in a Gray Zone When Abortion Laws and Emergency Care Mandate Conflict
Since the U.S. Supreme Court overturned Roe v. Wade in June, ER doctors say they — and their patients — are trapped between state anti-abortion laws and the federal law requiring that care be delivered in emergency situations. Women’s lives hang in the balance.
Biden’s FTC Has Blocked 4 Hospital Mergers and Is Poised to Thwart More Consolidation Attempts
The president has directed the Federal Trade Commission to carefully consider health industry mergers that may stymie competition and drive up prices. The new Democratic majority appears eager to look beyond traditional hospital consolidations to deals that involve products, services, or staffing.
FTC Official: Antitrust Push in Health Care Must Focus on a Merger’s ‘Human Impact’
Mark Seidman, an assistant director in the Federal Trade Commission’s Bureau of Competition, talks with KHN about efforts to police consolidation among hospitals and other health care providers.
Digital Mental Health Companies Draw Scrutiny and Growing Concerns
Consumers who have trouble getting in to see a therapist are turning to online behavioral health providers that offer quick access. But there’s limited research on their effectiveness.
States Watching as Massachusetts Takes Aim at Hospital Building Boom and Costs
A Massachusetts health care cost watchdog agency helped block plans of the state’s largest hospital system to expand into the suburbs. Now, other states are looking at whether Massachusetts’ decade-old model of controlling health costs is worth emulating.
Biden Pledges Better Nursing Home Care, but He Likely Won’t Fast-Track It
CMS chief Chiquita Brooks-LaSure says the agency reserves its power to quickly institute new regulations for “absolute emergencies.” On staffing, nursing home residents might need to wait years to see any real change.
Resistance to a Boston Hospital’s Expansion Centers on Rising Prices
Mass General Brigham’s $2.3 billion expansion plan is raising state officials’ concerns that it will reduce competition and raise the price of care in Massachusetts. It also signals a national shift from a focus on hospital mergers and purchases of physician practices — which boost the cost of care — to individual hospitals’ expansions to gain a bigger share of the market.
La catarata de información sobre la inscripción a Medicare no explica bien las opciones de Medigap
En parte porque las políticas sobre el acceso y los costos de Medigap cambian dependiendo del estado, o por la información confusa, muchos beneficiarios no eligen lo que más les conviene.
Medicare Enrollment Blitz Doesn’t Include Options to Move Into Medigap
TV ads and mailings targeting seniors tout Medicare Advantage plans this time of year, but millions choosing traditional Medicare make a costly and difficult decision about Medigap coverage, which gets much less attention.
Though Millions Are at Risk for Diabetes, Medicare Struggles to Expand Prevention Program
Medicare has proposed revamping its payment rules to get more people into a diabetes prevention plan that helps them eat better, exercise more and maintain a healthier lifestyle. Out of an estimated 16 million Medicare beneficiaries whose excess weight and other risk factors make them eligible, only 3,600 have participated since 2018.
Federal Speech Rulings May Embolden Health Care Workers to Call Out Safety Issues
Policies mandating company approval before talking publicly about conditions in hospitals have been a source of conflict over the past year, as physicians, nurses and other health workers have been disciplined for speaking or posting about what they view as dangerous covid-19 safety precautions. The appeals court’s decision could mean that hospitals — and other employers — will need to revise their policies.
FDA Weighs Approval of a Lucrative Alzheimer’s Drug, but Benefits Are Iffy
The agency is to decide by June 7 whether to greenlight Biogen’s drug aducanumab, despite a near-unanimous rejection of the product by an FDA advisory committee of outside experts in November. Some scientists at the agency have endorsed the drug, though.
Big Investors Push Nursing Homes to Upgrade Care and Working Conditions
Responsible for 34% of the nation’s covid death toll, nursing homes and long-term care facilities get slammed by their investors and are told to change.
FDA Seeks a New Way to Review Old Drugs Without Causing Prices to Soar
A misguided federal program called the Unapproved Drugs Initiative, which put the FDA’s stamp of approval on old drugs, led to higher prices. It’s scrapped. So now what?