Latest KFF Health News Stories
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.
Medicare Surprise: Drug Plan Prices Touted During Open Enrollment Can Rise Within a Month
Even the savviest Medicare drug plan shoppers can get a shock when they fill prescriptions: That great deal on medications is no bargain after prices go up.
After Medical Bills Broke the Bank, This Family Headed to Mexico for Care
The Fierro family owed a Yuma, Arizona, hospital more than $7,000 for care given to mom and dad, so when a son dislocated his shoulder, they headed to Mexicali. The care was quick, good, and affordable.
La familia Fierro le debe a un hospital de Yuma, Arizona, más de $7,000 por dos situaciones médicas. Así que cuando uno de los hijos se dislocó el hombro, fueron a Mexicali, México. La atención fue rápida, buena y económica.
Is My Drug Copay Coupon a Form of Charity — Or a Bribe?
Drug copayment assistance is a form of profitable charity — and, yes, that’s an oxymoron. Amid skyrocketing drug prices, it’s understandable that patients desperately need help affording medicine, especially when their health is on the line. But these programs create a mirage that perpetuates our health care system’s reckless spending.
Battle Lines Are Drawn Over California Deal With Kaiser Permanente
A controversial proposal to grant HMO giant Kaiser Permanente a no-bid statewide Medicaid contract is headed for its first legislative hearing amid vocal opposition from a coalition of counties, competing health plans, community clinics, and a national health care labor union.
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.
An $80,000 Tab for Newborns Lays Out a Loophole in the New Law to Curb Surprise Bills
The insurance company said that the birth of the Bull family’s twins was not an emergency and that NICU care was “not medically necessary.” The family’s experience with a huge bill sent to collections happened in 2020, but it exposes a hole in the new No Surprises law that took effect Jan. 1.
In May 2021, Lags Medical Centers, one of California’s largest chains of pain clinics, abruptly closed its doors amid a cloaked state investigation. Nine months later, patients are still in the dark about what happened with their care and to their bodies.
California Inks Sweetheart Deal With Kaiser Permanente, Jeopardizing Medicaid Reforms
The backroom deal with politically connected Kaiser Permanente, which infuriated other Medi-Cal health plans, allows the health care giant to continue selecting the enrollees it wants.
‘Then the Bill Came’: Year 4 of KHN-NPR’s Bill of the Month Is a Wrap
Our crowdsourced investigation of the high, confusing and arbitrary medical bills generated by our health system is set to begin its fifth year in 2022.
An Anesthesiology Practice’s Busy Day in Court Collecting on Surprise Bills
Legislative crackdowns on out-of-network bills haven’t kept specialists from hitting patients with unexpected charges running into thousands of dollars.
Stranded by the Pandemic, He Had Only Travel Insurance. It Left Him With a $38,000 Bill.
Although it’s possible to buy travel insurance that provides some health coverage, the devil is in the fine print. Obama-era laws that prevent refusal of payment for preexisting conditions don’t apply to travel insurance.
KHN’s ‘What the Health?’: Why Health Care Is So Expensive, Chapter $22K
Congress is making slow progress toward completing its ambitious social spending bill, although its Thanksgiving deadline looks optimistic. Meanwhile, a new survey finds the average cost of an employer-provided family plan has risen to more than $22,000. That’s about the cost of a new Toyota Corolla. Alice Miranda Ollstein of Politico, Anna Edney of Bloomberg News and Rebecca Adams of CQ Roll Call join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Rebecca Love, a nurse academic and entrepreneur, about the impending crisis in nursing.
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.
