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A Texas Lawsuit Being Heard This Week Could Mean Life Or Death For The ACA

By Julie Rovner September 4, 2018 KFF Health News Original

On Wednesday, a federal judge in Fort Worth, Texas, is set to hear arguments from Republican attorneys general who want him to strike down the federal health law and from Democratic counterparts who say the law is constitutional and should remain.

A Transgender Woman’s ‘Bait-And-Switch’ $92,000 Surgery Bill

By Emmarie Huetteman July 26, 2018 KFF Health News Original

After being promised a significant discount for paying cash upfront and forgoing insurance, a Wisconsin patient gets caught in the middle between hospital and insurer — and feels snookered by a last-minute surprise and billing snafu.

More Than Half Of California Nursing Homes Balk At Stricter Staffing Rules

By Barbara Feder Ostrov December 7, 2018 KFF Health News Original

Patient advocates say the state’s new staffing regulations are a good start toward better protecting the frail, but the nursing home industry contends they’re too burdensome.

Doctors Give Medicare’s Proposal To Pay For Telemedicine Poor Prognosis

By Phil Galewitz October 10, 2018 KFF Health News Original

Federal officials are proposing that Medicare pay doctors for a 10-minute “check-in” call with beneficiaries. But many doctors already do this for free, and the plan would require a cost-sharing charge of many patients.

Some Rough Waters May Upend Hopes For Smooth Sailing On Bipartisan Push To Lower Drug Prices

March 14, 2019 Morning Briefing

Combating high drug costs has been universally looked at as one of the few bipartisan issues that might get through the divided Congress. But the cracks are already starting to show even when it comes to relatively small-scale bills. Meanwhile, lawmakers are calling pharmaceutical benefit manager executives to appear in Congress next month.

Tennessee-Based Pain Management Group To Close Clinics Amid Financial Turmoil

By Fred Schulte July 3, 2018 KFF Health News Original

The CEO of Comprehensive Pain Specialists was indicted in April. Now the group is closing clinics across several states.

Can Insurers Use Genetic Testing Results? A Reader Wants To Know

By Michelle Andrews July 10, 2018 KFF Health News Original

Other readers ask what can be done to challenge unexpected medical bills — whether the result of an emergency room visit or after a change in prescription drug coverage.

Medicare Advantage Plans Shift Their Financial Risk To Doctors

By Phil Galewitz October 8, 2018 KFF Health News Original

Some private Medicare Advantage plans are offering large physician-management companies more money upfront and control of their patients’ care, but the doctors are responsible for staying within the budget.

‘Grossly Unfair’? Widower Takes Ban On Military Injury Claims To Supreme Court

By JoNel Aleccia Photos by Heidi de Marco October 11, 2018 KFF Health News Original

When a young Navy lieutenant died following low-risk childbirth, her husband claimed military doctors botched her care. But his wrongful death claim was dismissed because of a 1950 ruling that bars active-duty service members from suing the U.S. government — for any reason.

Giuliani’s Consulting Firm Helped Halt Purdue Opioid Investigation In Florida

By Fred Schulte September 5, 2018 KFF Health News Original

Post-9/11, Giuliani Partners helped craft a plan that put a halt to a probe into Purdue’s marketing of OxyContin.

Postpartum Psychosis Is Real, Rare And Dangerous

By April Dembosky, KQED January 25, 2019 KFF Health News Original

Postpartum psychosis is rare but very real, doctors say. And, unlike in some countries, U.S. moms who need inpatient psychiatric care can’t bring along their babies, adding to the trauma.

Gavin Newsom Is Bullish On Single-Payer — Except When He’s Not

By Brian Rinker October 23, 2018 KFF Health News Original

The front-runner in the California governor’s race, known for his political audacity, has officially endorsed the controversial move to create one public insurance program for all Californians. Yet he also faces formidable challenges, and liberal critics fear he’ll retreat.

A Transgender Woman’s Quest For Surgery Caught In Political Crosswinds

By Emmarie Huetteman July 26, 2018 KFF Health News Original

Dramatic policy swings, from an unprecedented expansion of transgender rights under the Obama administration to the unpredictable reduction of trans rights under President Donald Trump, have left many trans Americans feeling the whiplash.

GOP Gubernatorial Candidate John Cox: Limit Government In Health Care

By Samantha Young October 17, 2018 KFF Health News Original

John Cox, California’s Republican candidate for governor, contends that policies on abortion, health insurance and health care access should be guided by the conservative ideals of free market competition and personal responsibility. He hasn’t offered specific policy positions on health care, except that government should largely stay out of it.

Black Market For Suboxone Gives Some A Glimpse Of Recovery

By Jake Harper, Side Effects Public Media October 9, 2018 KFF Health News Original

Addiction experts argue that buprenorphine, which drug users buy on the street, actually saves lives because it is used in place of more dangerous substances, like heroin and fentanyl.

Missed Visits, Uncontrolled Pain And Fraud: Report Says Hospice Lacks Oversight

By Melissa Bailey July 31, 2018 KFF Health News Original

A new government watchdog report outlines vulnerabilities in Medicare’s $17 billion hospice program, pointing to inadequate services, inappropriate billing and outright fraud.

Father’s And Son’s Injuries Lead To The Mother Of All Therapy Bills

By Stephanie O'Neill Photos by Heidi de Marco June 29, 2018 KFF Health News Original

A father and son suffered serious hand injuries nine days apart. They both needed surgery and lots of follow-up occupational therapy to rehab their hands. But insurance paid for just a fraction of those OT bills, and the family owed more than $8,500.

California’s ACA Rates To Rise 8.7% Next Year

By Chad Terhune and Pauline Bartolone July 19, 2018 KFF Health News Original

The average increase in California is smaller than the double-digit hikes expected around the nation, due largely to a healthier mix of enrollees and more competition in its marketplace. Still, health insurance prices keep growing faster than wages and general inflation.

What A U.S.-China Trade War Could Mean For The Opioid Epidemic

By Matthew Garcia July 6, 2018 KFF Health News Original

The nation’s effort to combat this public health crisis could get caught in the crossfire of the Trump administration’s trade policies.

Insurers Fall Short In Catching And Reporting Medicaid Fraud, Inspectors Find

By Chad Terhune July 12, 2018 KFF Health News Original

Medicaid has struggled for years with poor oversight and billions lost to improper payments. A new report finds that despite their fraud-fighting rhetoric, Medicaid managed-care companies are not as rigorous as they should be in ensuring the integrity of the Medicaid payment system.

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