How Medicare Advantage Plans Dodged Auditors and Overcharged Taxpayers by Millions
Facing rare scrutiny from federal auditors, some Medicare Advantage health plans failed to produce any records to justify their payments, government records show. The audits revealed millions of dollars in overcharges to Medicare over three years.
In Rural America, Deadly Costs of Opioids Outweigh the Dollars Tagged to Address Them
Some people say it’s reasonable for densely populated areas to receive more settlement funds, since they serve more of those affected. But others worry this overlooks rural communities disproportionately harmed by opioid addiction.
KHN Investigation: The System Feds Rely On to Stop Repeat Health Fraud Is Broken
A months-long KHN examination of the system meant to bar fraudsters from Medicaid, Medicare, and other federal health programs found gaping holes and expansive gray areas through which banned individuals slip to repeatedly bilk taxpayer-funded programs.
Para lanzar un nuevo fármaco al mercado, la Administración de Alimentos y Medicamentos (FDA) exige a las farmacéuticas estudios exhaustivos para demostrar su seguridad y eficacia. Conseguir que un medicamento salga al mercado unos meses antes, y con menos gastos de lo habitual, puede traducirse en beneficios millonarios para el fabricante.
The Business of Clinical Trials Is Booming. Private Equity Has Taken Notice.
Private equity-backed Headlands Research heralded its covid-19 vaccine trials as a chance to boost participation among diverse populations, then it shuttered multiple sites that conducted them.
An Unexplained Injury Discovered After Eye Surgery. What Should Happen Next?
Some doctors and medical practices voluntarily give rebates on a bill if an injury occurs during a procedure, while others will not, an expert says. Here’s how patients can respond.
Cuando hay mala praxis en centros de salud comunitarios, pagan los contribuyentes
Los 1,375 centros de salud financiados con dinero federal, que atienden a 30 millones de estadounidenses de bajos ingresos, son en su mayoría organizaciones privadas. Sin embargo, reciben $6,000 millones anuales en subvenciones federales y, según la ley federal, sus responsabilidades legales están cubiertas por el gobierno
When Malpractice Occurs at Community Health Centers, Taxpayers Pay
Federally funded clinics and their doctors are protected against lawsuits by federal law, with taxpayers footing the bill. The health centers say that allows them to better serve their low-income patients, but lawyers say the system handcuffs consumers with a cumbersome legal process and makes it harder for the public to see problems.
Schools, Sheriffs, and Syringes: State Plans Vary for Spending $26B in Opioid Settlement Funds
The cash represents an unprecedented opportunity to derail the opioid epidemic, but with countless groups advocating for their share of the pie, the impact could depend heavily on geography and politics.
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.
How Banks and Private Equity Cash In When Patients Can’t Pay Their Medical Bills
Hospitals strike deals with financing companies, generating profits for lenders, and more debt for patients.
The Player-Coaches of Addiction Recovery Work Without Boundaries
States, tribes, and local governments are figuring out how best to spend billions of dollars from an opioid lawsuit settlement. One option they’re considering is funding peer support specialists, who guide people recovering from addiction as they do it themselves.
Private equity firms have shelled out almost $1 trillion to acquire nearly 8,000 health care businesses, in deals almost always hidden from federal regulators. The result: higher prices, lawsuits, and complaints about care.
Knoxville’s Black Community Endured Deeply Rooted Racism. Now There Is Medical Debt.
Despite the end of Jim Crow segregation, its legacy lives on in medical debt that disproportionately burdens Black communities.
$38,398 for a Single Shot of a Very Old Cancer Drug
Lupron, a drug patented half a century ago, treats advanced prostate cancer. It’s sold to physicians for $260 in the U.K. and administered at no charge. Why are U.S. hospitals — which may pay nearly as little for the drug — charging so much more to administer it?
A Billing Expert Saved Big After Finding an Incorrect Charge in Her Husband’s ER Bill
A medical billing specialist investigated her husband’s ER bill. Her sleuthing took over a year but knocked thousands of dollars off the hospital’s charges — and provides a playbook for other consumers.
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.
Baby, That Bill Is High: Private Equity ‘Gambit’ Squeezes Excessive ER Charges From Routine Births
Hospitals, boosted by private equity-backed staffing companies, have embraced a new idea: the obstetrics emergency department. Often, it is just a triage room in the labor-and-delivery area, but it bills like the main emergency department.
Medical Debt Sunk Her Credit. New Changes From the Credit Reporting Agencies Won’t Help.
New policies to prevent unpaid medical bills from harming people’s credit scores are on the way. But the concessions made by top credit reporting companies may fall short for those with the largest debt — especially Black Americans in the South.
Listen: Medical Bills Upended Her Life and Her Credit Score
Penny Wingard, 58, of Charlotte, North Carolina, worries she won’t ever get out from under her medical debt despite new policies that are supposed to prevent medical debt from harming people’s credit scores.
