Latest KFF Health News Stories
Why Does Insulin Cost So Much? Big Pharma Isn’t the Only Player Driving Prices
Big Pharma may be moving on from squeezing diabetes patients on insulin prices, but it’s the arbitrators that jack up prices for those who can least afford them.
Government Lets Health Plans That Ripped Off Medicare Keep the Money
In a surprise decision, U.S. officials yield to insurance industry demands — at least for now.
‘An Arm and a Leg’: Getting Insurance to Pay for Oral Surgery Is Like Pulling Teeth
A car crash left a woman in need of oral surgery, but her health insurance wouldn’t cover it. Her ongoing fight shows podcast host Dan Weissmann the weird way insurance treats teeth and reveals a big problem in the Obamacare marketplace.
Employers Use Patient Assistance Programs to Offset Their Own Costs
Some insurers and employers are tapping into assistance programs meant for individual patients. The concern: Some costly drugs could be harder for patients to access.
The Disability Tax: Medical Bills Remain Inaccessible for Many Blind Americans
Health insurers and health care systems across the country are violating disability rights laws by sending medical bills that blind and visually impaired people cannot read, a KHN investigation has found. By hindering the ability of blind Americans to know what they owe, some bills get sent to debt collections.
Audits — Hidden Until Now — Reveal Millions in Medicare Advantage Overcharges
Taxpayers had to foot the bills for care that should have cost far less, according to records released after KHN filed a lawsuit under the Freedom of Information Act. The government may seek to recover up to $650 million as a result.
Hospital Giant HCA Fends Off Accusations of Questionable Inpatient Admissions
The nation’s largest private health system, HCA Healthcare, has faced years of scrutiny over its share of emergency room patients who are admitted to the hospital. And now U.S. Rep. Bill Pascrell, a Democrat from New Jersey, is calling for a federal investigation, prompting an escalating defense by the hospital system, based in Nashville, Tennessee.
Kids’ Mental Health Care Leaves Parents in Debt and in the Shadows
A youth mental health crisis and a shortage of therapists and other care providers who take insurance are pushing many families into financial ruin. But it’s rarely acknowledged as medical debt.
Centene to Pay $166 Million to Texas in Medicaid Drug Pricing Settlement
Texas is at least the 12th state to settle with St. Louis-based Centene Corp. over allegations that it overcharged Medicaid prescription drug programs.
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.
Medical Coding Creates Barriers to Care for Transgender Patients
The codes used by U.S. medical providers to bill insurers haven’t caught up to the needs of trans patients or even international standards. Consequently, doctors are forced to get creative with what codes they use, or patients spend hours fighting big out-of-pocket bills.
Timely Mental Health Care Is a Key Factor in Strike by Kaiser Permanente Workers
A new California law requires timely follow-up appointments for mental health and addiction patients. But striking workers at Kaiser Permanente in Northern California say patients continue to wait up to two months.
Health Insurance Price Data: It’s Out There, but It’s Not for the Faint of Heart
Health insurers and self-insured employer plans are now required to post their negotiated rates for almost every type of medical service. But navigating through the trove of information is no easy task.
Even Well-Intended Laws Can’t Protect Us From Inaccurate Provider Directories
State and federal laws require health plans to offer accurate lists of participating doctors and facilities, but consumers still struggle to get timely appointments with providers.
Ad Targeting Manchin and AARP Mischaracterizes Medicare Drug-Price Negotiations
The advocacy group American Commitment said empowering Medicare to negotiate drug prices would raid it of billions of dollars. Drug pricing experts say that that’s not the case and that such policies would instead reduce costs for the Medicare program and seniors.
No-Bid Medicaid Contract for Kaiser Permanente Is Now California Law, but Key Details Are Missing
California Gov. Gavin Newsom signed a bill last month that authorizes a statewide Medicaid contract for HMO giant Kaiser Permanente. But details still need to be worked out in a memorandum of understanding.
Es cierto que pequeños cambios en los ingresos pueden hacer que la elegibilidad cambie, pero si se ingresa información incorrecta en un sistema informático compartido por Covered California y Medi-Cal, o se elimina información precisa, eso les puede causar grandes dolores de cabeza a los afiliados.
Computer Glitches and Human Error Still Causing Insurance Headaches for Californians
Covered California and Medi-Cal share a computer system for eligibility and enrollment. Nearly a decade since the Affordable Care Act expanded coverage options in the state, enrollees can be diverted to the wrong program — or dropped altogether — if erroneous information gets into the system.
Her First Colonoscopy Cost Her $0. Her Second Cost $2,185. Why?
Preventive care, like screening colonoscopies, is supposed to be free of charge to patients under the Affordable Care Act. But some hospitals haven’t gotten the memo.
Why So Slow? Legislators Take on Insurers’ Delays in Approving Prescribed Treatments
Insurers say prior authorization requirements are intended to reduce wasteful and inappropriate health care spending. But they can baffle patients waiting for approval. And doctors say that insurers have yet to follow through on commitments to improve the process.
