Investigations

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.

KHN-NPR’s ‘Bill of the Month’ at 5: A Treasury of Solutions for Confounding Medical Bills

Readers and listeners shared more than 1,000 personal stories of medical billing problems with KHN-NPR’s “Bill of the Month” investigative series this year, helping us illuminate the financial decisions patients are pressed to make in their most vulnerable moments.

ER Doctors Call Private Equity Staffing Practices Illegal and Seek to Ban Them

Doctors, consumer advocates, and some lawmakers are looking forward to a California lawsuit against private equity-backed Envision Healthcare. The case is part of a multistate effort to enforce rules banning corporate ownership of physician practices.

The Case of the Two Grace Elliotts: A Medical Billing Mystery

A health system charged a woman for a shoulder replacement at a hospital across the country that she had not visited for years. She didn’t receive the care, but she did receive the bill — and the medical records of a stranger.

A Medical Cost-Sharing Plan Left Pastor With Most Of The Cost

Jeff and Kareen King joined a medical cost-sharing plan advertised as a “refreshing non-insurance approach” to paying for health care. It had a big proviso: Preexisting conditions like Jeff’s heart condition were not fully covered for the first two years. He needed heart surgery after just 16 months.

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.

Empresas de capital riesgo invierten en el negocio de los ensayos clínicos de medicamentos. ¿Cuál es el riesgo para los pacientes?

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.