Latest KFF Health News Stories
When Rogue Brokers Switch People’s ACA Policies, Tax Surprises Can Follow
Some tax filers’ returns are being rejected because they failed to provide information about Affordable Care Act coverage they didn’t even know they had.
Unauthorized Sign-Ups Cast Shadow on Obamacare’s Record Enrollment
The Biden administration faces what looks like a growing problem for the federal Affordable Care Act’s insurance exchange: disreputable insurance brokers enrolling people who don’t need coverage or switching them to new plans without their authorization. It happened to Michael Debriae, a restaurant server who lives in Charlotte. Unbeknownst to him, an agent in Florida […]
Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage
Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. There’s a way out.
Biden Cracks Down on Prior Authorization — But There Are Limits
More than a year after it was initially proposed, the Biden administration announced a final rule yesterday that will change how insurers in federal programs such as Medicare Advantage use prior authorization — a long-standing system that prevents many patients from accessing doctor-recommended care. “When a doctor says a patient needs a procedure, it is […]
Will CMS Crack Down on Prior Authorization?
There’s the Idaho doctor whose infant daughter developed a brain tumor. A woman in Southern California who waited months for an MRI before dying in the hospital. And a North Carolina patient who has trigeminal neuralgia — a condition so painful it’s commonly called the “suicide disease.” They all have something in common, aside from […]
Readers Slam Hospital Monopolies and Blame the Feds for Understaffed Nursing Homes
KFF Health News gives readers a chance to comment on a recent batch of stories.
Medicaid’s ‘Unwinding’ Can Be Especially Perilous for Disabled People
Earlier this year, Beverly Likens thought she’d done everything she needed to do to keep her Medicaid. Then came an unwelcome surprise: Ahead of surgery to treat chronic bleeding, the hospital said her insurance was inactive, jeopardizing her procedure. Likens had just been diagnosed with severe anemia and given a blood transfusion at the emergency room. “I […]
Lost in the Mix of Medicaid ‘Unwinding’: Kentucky Cut Off Her Health Care Over a Clerical Error
The state canceled Beverly Likens’ coverage — days before surgery — without considering other ways she qualified for Medicaid, which experts say violated federal regulations.
Nursing Homes Say They Can’t Afford Higher Staffing. But Their Finances Are Often Opaque.
Perhaps the biggest mystery, as the Biden administration moves to force nursing homes to boost staffing, is this: how much extra money do the nation’s 15,000 homes actually have to hire and retain more nurses and aides? Public comments are due Monday on the most sweeping regulatory changes to hit the industry in decades. The […]
Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients
Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and then predicts what kind of care an individual will need and for how long. New federal rules will ensure human experts are part of the process.
These Appalachia Hospitals Made Big Promises to Gain a Monopoly. They’re Failing to Deliver.
Ballad Health, the only hospital system across a large swath of Tennessee and Virginia, has fallen short of quality-of-care and charity care obligations — even as it’s sued thousands of patients for unpaid bills.
Biden Administration Proposes New Standards to Boost Nursing Home Staffing
The proposal would require major hiring at the most sparsely staffed homes. But the proposal is already badly received by the nursing home industry, which claims it can’t boost wages enough to attract workers.
Exclusive: CMS Study Sabotages Efforts to Bolster Nursing Home Staffing, Advocates Say
Research commissioned by the Centers for Medicare & Medicaid Services analyzed only staffing levels below what experts have previously called ideal. Patient advocates have been pushing for more staff to improve care.
After Backlash, Feds Cancel Plan That Risked Limiting Breast Reconstruction Options
The Centers for Medicare & Medicaid Services backed off from a plan that could have curtailed access to a type of reconstructive surgery known as DIEP flap. Breast cancer patient advocates are relieved.
Look Up Your Hospital: Is It Being Penalized by Medicare?
Each year, Medicare punishes hospitals that have high rates of readmissions and high rates of infections and patient injuries. Check out which hospitals have been penalized.
The Real Costs of the New Alzheimer’s Drug, Most of Which Will Fall to Taxpayers
The annual cost of lecanemab treatment quadruples if the expense of brain scans to monitor for bleeds and other associated care is factored in. The full financial toll likely puts it beyond reach for low-income seniors at risk of Alzheimer’s, experts say.
KFF Health News' 'What the Health?': Let’s Talk About the Weather
It’s been the summer of broken weather records around the world — for heat, rain, and wildfire smoke — advertising the risks of climate change in a big way. But, apparently, it’s not enough to break the logjam in Washington over how to address the growing climate crisis. Meanwhile, in Texas, women who were unable to get care for pregnancy complications took their stories to court, and Congress gears up to — maybe — do something about prescription drug prices. Alice Miranda Ollstein of Politico, Shefali Luthra of The 19th, and Rachel Cohrs of Stat join Julie Rovner, KFF Health News’ chief Washington correspondent, to discuss these issues and more. Also this week, Rovner interviews Meena Seshamani, the top administrator for the federal Medicare program.
How a Medical Recoding May Limit Cancer Patients’ Options for Breast Reconstruction
The federal government’s arcane process for medical coding is influencing which reconstructive surgery options are available, creating anxiety for breast cancer patients.
Falta de doctores y residencias médicas impactan en la salud de las zonas rurales
Expertos dicen que los factores sistémicos son barreras comunes para establecer y mantener programas de capacitación para médicos en las zonas rurales de Estados Unidos.
Doctor Shortages Distress Rural America, Where Few Residency Programs Exist
Patients in rural northeastern Nevada soon will have fewer providers and resources, after a local hospital decided to close its medical residency program. Nationally, the number of rural residency slots has grown during the past few years but still makes up just 2% of programs and residents nationwide.
