Insurance Coverage & Costs 010522
NICU Bill Installment Plan: That’ll Be $45,843 a Month for 12 Months, Please
Victoria Knight
After baby Dorian Bennett arrived two months early and spent more than 50 days in the neonatal ICU, his parents received a bill of more than $550,000 — despite having insurance. The Florida hospital had a not-so-helpful suggestion: monthly payments of more than $45,000 for a year.
‘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.
Record Number of Americans Sign Up for ACA Health Insurance
Phil Galewitz and Andy Miller
Nearly 14 million Americans have enrolled in Affordable Care Act marketplace health plans for next year — a record since the health law’s coverage expansion took effect in 2014. A boost in subsidies marketing and assistance in navigating the process increased the rolls of the insured.
A Tale of Two Medicaid Expansions: Oklahoma Jumps In, While Missouri Lags
Bram Sable-Smith
Voters in Missouri and Oklahoma approved Medicaid expansion to begin in 2021. But while Oklahoma has enrolled over 200,000 people so far, Missouri has enrolled fewer than 20,000. Why are two such similar states handling the public insurance rollout so differently?
New Parents Slapped With Surprise Bills for Treating Newborns
Jay Hancock
Regular use of a more advanced screening method turns a low-cost procedure into a pricier one.
An Anesthesiology Practice’s Busy Day in Court Collecting on Surprise Bills
Jay Hancock
Legislative crackdowns on out-of-network bills haven’t kept specialists from hitting patients with unexpected charges running into thousands of dollars.
Crash Course: Injured Patients Who Sign ‘Letters of Protection’ May Face Huge Medical Bills and Risks
Fred Schulte
The letters function as liens that “protect” spine surgery clinics while patients could be left with inflated medical bills and unexpected health risks.
Post-Pandemic, What’s a Phone Call From Your Physician Worth?
Julie Appleby
Medicare billing codes for audio-only follow-up check-ins lead to new reimbursement battles.
Layers of Subcontracted Services Confuse and Frustrate Medi-Cal Patients
Bernard J. Wolfson
Many of the 14 million patients in Medi-Cal are in managed care health plans that outsource their care to subcontractors or sub-subcontractors. For patients with difficult health care needs, it can be hard to know where to turn.
Mattresses and Mold Removal: Medi-Cal to Offer Unconventional Treatments to Asthma Patients
Angela Hart
In January, California’s Medicaid program will begin offering nontraditional services —such as ridding homes of roaches, replacing mattresses and installing air purifiers — to some low-income asthma patients. But the rollout could be chaotic, with insurance companies struggling to identify groups that can deliver the services.
Covered California’s Insurance Deals Range From ‘No-Brainer’ to Sticker Shock
Bernard J. Wolfson
Families of four with incomes of less than about $40,000 a year can pay no premiums and have low deductibles. For some others, health insurance in 2022 will cost more than in 2021 — in some cases, significantly more.
With Sexually Transmitted Infections Off the Charts, California Pushes At-Home Tests
Rachel Bluth
A new law makes California the first state to require that health insurance plans, including Medicaid, cover home STI tests. But some details still need to be worked out.
Nursing Homes Bleed Staff as Amazon Lures Low-Wage Workers With Prime Packages
Sarah Varney
Add nursing homes to the list of industries jolted by Amazon’s handsome hourly wages. Enticed by an average starting pay rate of $18 an hour and the potential for benefits and signing bonuses, low-wage workers are fleeing entry-level elder care for jobs packing boxes.
Rural Communities Left Hurting Without a Hospital, Ambulance or Doctors Nearby
Andy Miller
Rural areas such as Echols County, Georgia, have high levels of uninsured people and profound physician shortages that compound the lack of health care options, especially in the 12 states that have not expanded Medicaid.
Seeking Refills: Aging Pharmacists Leave Drugstores Vacant in Rural America
Markian Hawryluk
Independent pharmacists who want to retire often have trouble attracting new pharmacists to take over their practices, particularly in rural areas. That can cause smaller towns to lose their pharmacies. With many pharmacists near retirement, the problem may only get worse.
Local Pharmacists Fill Rx Void as Big Brands Pull Out of Rural Areas
Markian Hawryluk
Stores like Walmart and Shopko opened pharmacies in small towns, either buying out the local pharmacy or driving it out of business. What happens when those chains later withdraw, leaving communities with no pharmacy?
Deep Roots Help This Chicago Pharmacist Avoid Creating Another Drugstore Desert
Markian Hawryluk
Predominantly Black and Hispanic urban areas are more likely than white neighborhoods to see local pharmacies close and are more likely to be pharmacy deserts. In Chicago, one pharmacist is bucking the trend, operating the drugstore his father opened in the 1960s in a Black neighborhood.
‘The Charges Seem Crazy’: Hospitals Impose a ‘Facility Fee’ — For a Video Visit
Michelle Andrews
Facility fees, designed to help hospitals cover the high cost of staying open 24/7, have long rankled consumers. Now, some patients are assessed the fees while sitting at home for a telehealth appointment.
Suit by Doctors, Hospitals Seeks Change in How Arbitrators Settle Surprise Billing Cases
Julie Appleby
The American Medical Association and American Hospital Association are not arguing to halt the law that protects patients from unexpected bills from providers they didn’t know were outside their insurance network. Instead, they want to change the rules for the mediators who will settle the dispute between insurers and providers.
From ‘Physician Assistant’ to Medicare, Readers and Tweeters Mince No Words
KHN gives readers a chance to comment on a recent batch of stories.
Oncology Doctors Say the Build Back Better Act Will Slash Cancer Care Funding — A Skewed Argument
Julie Appleby
The Community Oncology Alliance is targeting the prescription drug provisions of the Build Back Better Act, saying they will trigger deep cuts in oncologists’ pay, causing clinics to close and health care costs to rise. But it leaves out some important details.
Texas Toughens Ban on Medication-by-Mail Abortions With Jail Time and Hefty Fine
Ashley Lopez, KUT
Last week, on the same day the Supreme Court heard a case that could overturn Roe v. Wade, the landmark ruling on abortion rights, Texas enacted a law that creates criminal penalties for anyone who prescribes medication abortions via telehealth or mail.
Why an HBCU Med School Decided to Put CARES Act Money Into Students’ Pockets
Blake Farmer, Nashville Public Radio
More than most schools, the country’s historically Black colleges and universities are funneling stimulus money directly to students, wiping out loans and past-due fees. But one is going a step further with its financial assistance.
As Covid Hits Nursing Homes’ Finances, Town Residents Fight to Save Alzheimer’s Facility
Judith Graham
Fear of covid has kept some adults from moving to nursing homes, and many facilities are in trouble financially. When Nevada, Missouri, officials announced they were planning to close a home specializing in dementia care, members of the community rose up in protest.
KHN’s ‘What the Health?’: Manchin Blows Up Biden’s ‘Build Back Better’
Sen. Joe Manchin (D-W.Va.) dealt a blow to congressional efforts to pass President Joe Biden’s domestic agenda bill, forcing Democrats to regroup starting in 2022. Meanwhile, the omicron covid variant spreads rapidly in the U.S., threatening the stability of the nation’s health care system. Joanne Kenen of Politico and the Johns Hopkins School of Public Health, Rachel Cohrs of Stat and Sarah Karlin-Smith of the Pink Sheet join KHN’s Julie Rovner to discuss these issues and more, plus a look back at the year in health policy. Also this week, Rovner interviews Ceci Connolly, president and CEO of the Alliance of Community Health Plans.
‘An Arm and a Leg’: She Fights Health Insurers for Fun — And Wins
Dan Weissmann
Law professor Jackie Fox looks at health insurance policies like any other contract, and she has spent 30 years making sound legal arguments to help patients get the care they need.
‘An Arm and a Leg’: The Rapid-Test Edition: Who’s Making a Buck?
Dan Weissmann
In this episode, host Dan Weissmann talks to reporters who investigated the shortage of tests and traced the U.S. rapid-testing problem back to government agencies.
Listen: How the New ‘No Surprises’ Law Tackles Unexpected Medical Bills
Years in the making, a new federal law against surprise medical bills took effect Jan. 1.
Con récord de infecciones de transmisión sexual, California impulsa las pruebas caseras
Rachel Bluth
California se ha convertido en el primer estado en exigir que los seguros médicos cubran las pruebas caseras para infecciones de transmisión sexual (ITS) como el VIH, la clamidia y la sífilis.