Insurance, Coverage, and Costs: Aug. 30, 2023
She Paid Her Husband’s Hospital Bill. A Year After His Death, They Wanted More Money.
Samantha Liss
A widow encountered a perplexing reality in medical billing: Providers can come after patients to collect well after a bill has been paid.
Timing and Cost of New Vaccines Vary by Virus and Health Insurance Status
Julie Appleby
Flu. Covid. RSV. When and how to get vaccinated against them can be confusing. Here are some of the most important things to know.
After Backlash, Feds Cancel Plan That Risked Limiting Breast Reconstruction Options
Rachana Pradhan and Anna Werner, CBS News and Leigh Ann Winick, CBS News
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.
Feds Say Hospitals That Redistribute Medicaid Money Violate Law
Samantha Young
Federal officials are trying to clamp down on private arrangements among some hospitals to pay themselves back for the Medicaid taxes they’ve paid. State health officials and the influential hospital industry argue that regulators have no jurisdiction over the agreements.
Proposed Rule Would Make Hospital Prices Even More Transparent
Julie Appleby
A Biden administration proposal would help standardize the data on prices that hospitals provide to patients, increase its usefulness to consumers, and boost enforcement. Previous rules gave hospitals too many loopholes.
Watch: As Opioid Settlement Money Starts to Flow, States and Local Officials Debate How to Use It
PBS NewsHour featured KFF Health News’ Aneri Pattani as it reported on how this debate is playing out in North Carolina and Ohio.
Journalists Sum Up the Costs to Patients of New Weight Loss Drugs and Hospital Mergers
KFF Health News and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here’s a collection of their appearances.
Patients in California County May See Refunds, Debt Relief From Charity Care Settlement
Molly Castle Work
As hospitals are criticized for skimping on financial assistance, Santa Clara County has agreed to notify 43,000 former patients of possible billing reductions as part of a settlement. Some patients had sued, alleging the county’s hospital system sent them to collections for bills they shouldn’t have received.
North Carolina Hospitals Have Sued Thousands of Their Patients, a New Report Finds
Noam N. Levey
An analysis of court records by the state treasurer and Duke researchers finds Atrium Health, originally a public hospital system, accounted for almost a third of the legal actions against North Carolina patients over roughly five years.
How a Surprise Bill Can Hitch a Ride to the Hospital
Dan Weissmann
The No Surprises Act has helped rein in out-of-network medical bills, but ground ambulances are a costly exception. Hear why this service can still hit patients with big bills and what to do if you get one.
5 Things to Know About the New Drug Pricing Negotiations
Arthur Allen and Rachana Pradhan and David Hilzenrath
The Biden administration unveiled the first 10 drugs subject to price negotiations, taking a swipe at the pharmaceutical industry. But what does it mean for patients?
A Peek at Big Pharma’s Playbook That Leaves Many Americans Unable to Afford Their Drugs
Elisabeth Rosenthal
Brand-name drug prices in the U.S. — more than three times the price in other developed countries — are related neither to the amount of research and development required to bring them to market nor their therapeutic value, recent research shows. Have drugmakers overplayed their hand?
Community With High Medical Debt Questions Its Hospitals’ Charity Spending
Markian Hawryluk
Pueblo, Colorado, residents have higher-than-average medical debt, while the city’s two tax-exempt hospitals provide relatively low levels of charity care.
California’s Medical Board Can’t Pay Its Bills, but Doctors Resist Proposed Fixes
Annie Sciacca
Patient advocates have long alleged the Medical Board of California is ineffective at policing doctors. But a proposal to beef up its budget and overhaul procedures faces stiff resistance from the doctors’ lobby.
Tribal Health Workers Aren’t Paid Like Their Peers. See Why Nevada Changed That.
Jazmin Orozco Rodriguez
Community health workers, who often help patients get to their appointments and pick up prescriptions for them, have increasingly been recognized as an integral part of treating chronic illnesses. But state-run Medicaid programs don’t always reimburse them equally, usually excluding those who work on tribal lands.
Life in a Rural ‘Ambulance Desert’ Means Sometimes Help Isn’t on the Way
Taylor Sisk
No local hospital and anemic ambulance services mean residents in rural Pickens County, Alabama, are thrown into perilous situations when they have medical emergencies. It’s a kind of medical care roulette that has become a fact of life for rural Americans who live in ambulance deserts.
California Offers Lifeline to 17 Troubled Hospitals
Bernard J. Wolfson
California’s new lending program for distressed hospitals will provide Madera Community Hospital with interest-free loans of up to $52 million if it can agree on a viable reopening plan with Adventist Health. The state will offer an additional $240.5 million in interest-free loans to 16 other troubled hospitals.
A Move to Cut Drug Prices Has Patients With Rare Diseases Worried
Markian Hawryluk
A Colorado board has named five drugs it will review for affordability and potential cost caps. But patients with cystic fibrosis worry they will lose access to a life-changing therapy.
Doctors and Patients Try to Shame Insurers Online to Reverse Prior Authorization Denials
Lauren Sausser
Prior authorization is a common tool used by health insurers for many tests, procedures, and prescriptions. Frustrated by the process, patients and doctors have turned to social media to publicly shame insurance companies and elevate their denials for further review.
Your Exorbitant Medical Bill, Brought to You by the Latest Hospital Merger
Elisabeth Rosenthal
After decades of unchecked mergers, health care is the land of giants, with huge medical systems monopolizing care in many cities, states, and even whole regions of the country. This decreases patient choice, impedes innovation, erodes quality of care, and raises prices. And federal regulators have been slow to act.
A New Medicare Proposal Would Cover Training for Family Caregivers
Judith Graham
The federal government is proposing having Medicare pay professionals to train family caregivers how to perform tasks like bathing and dressing their loved ones, and properly use medical equipment.
Lost Medicaid Health Coverage? Here’s What You Need to Know
Samantha Liss
Patient advocates are tackling the “overwhelming task” of connecting people with health insurance as millions lose coverage due to the end of pandemic protections on Medicaid eligibility.
On Abortion Rights, Ohio Is the New Kansas
Nearly a year to the day after Kansas voters surprised the nation by defeating an anti-abortion ballot question, Ohio voters defeated a similar, if cagier, effort to limit access in that state. This week, they rejected an effort to raise the threshold for approval of future ballot measures from a simple majority, which would have made it harder to protect abortion access with yet another ballot question come November. Meanwhile, the number of Americans without health insurance has dropped to an all-time low, though few noticed. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Rachel Roubein of The Washington Post, and Emmarie Huetteman of KFF Health News join KFF Health News’ chief Washington correspondent, Julie Rovner, to discuss these issues and more. Also this week, Rovner interviews Kate McEvoy, executive director of the National Association of Medicaid Directors, about how the “Medicaid unwinding” is going, as millions have their eligibility for coverage rechecked.
Lo que hay que saber para no perder Medicaid
Samantha Liss
Gran parte de los beneficiarios de Medicaid que perdieron la cobertura fue porque no completaron el papeleo necesario para permanecer en el seguro.