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Showing 1-20 of 1,995 results for "out-of-network"

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A photo of a mother holding her infant son while looking at medical bills.

A Mom’s $97,000 Question: How Was Her Baby’s Air-Ambulance Ride Not Medically Necessary?

By Molly Castle Work March 25, 2024 KFF Health News Original

There are legal safeguards to protect patients from big bills like out-of-network air-ambulance rides. But insurers may not pay if they decide the ride wasn’t medically necessary.

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An Arm and a Leg: Meet the Middleman’s Middleman

By Dan Weissmann June 25, 2024 Podcast

Why are patients facing bigger bills than they expect for out-of-network care? In this episode of “An Arm and a Leg,” the show explains the hidden mechanics of MultiPlan, a data firm that helps health insurers set these rates and make bigger returns.

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A photo shows a woman holding her infant child while facing a window.

Surprise-Billing Law Loophole: When ‘Out of Network’ Doesn’t Quite Mean Out of Network

By Harris Meyer February 28, 2023 KFF Health News Original

Billing experts and lawmakers are playing catch-up as providers find ways to get around new surprise-billing laws, leaving patients like Danielle Laskey of Washington state with big bills for emergency care.

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A photo of a man standing outside for a portrait with dramatic lighting.

Sign Here? Financial Agreements May Leave Doctors in the Driver’s Seat

By Katheryn Houghton April 30, 2024 KFF Health News Original

Agreeing to an out-of-network doctor’s own financial policy — which generally protects their ability to get paid and may be littered with confusing insurance and legal jargon — can create a binding contract that leaves a patient owing.

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Three ambulances are lined up outside of an emergency room of a children's hospital in Orange, CA.

New California Law Offers Fresh Protection From Steep Ambulance Bills

By Bernard J. Wolfson November 7, 2023 KFF Health News Original

The law, which takes effect Jan. 1, prohibits out-of-network ground ambulance operators from billing patients more than they would pay for in-network rides. It also caps how much the uninsured must pay.

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An Arm and a Leg: How a Surprise Bill Can Hitch a Ride to the Hospital

By Dan Weissmann August 16, 2023 Podcast

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.

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A photo shows Brenna Kearney sitting at home as her daughter, Joey, plays.

A Baby Spent 36 Days in an In-Network NICU. Why Did the Hospital Next Door Send a Bill?

By Harris Meyer January 30, 2023 KFF Health News Original

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.

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A photo of a young man posing for a portrait outside. A white car drives up the street behind him.

A Runner Was Hit by a Car, Then by a Surprise Ambulance Bill

By Sandy West February 28, 2025 KFF Health News Original

A San Francisco man had friends drive him to the hospital after he was hit by a car. Doctors checked him out, then sent him by ambulance to a trauma center — which released him with no further treatment. The ambulance bill? Almost $13,000.

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A photo of President Trump at the White House speaking into a microphone, pointing with his hand.

Trump Vowed To End Surprise Medical Bills. The Office Working on That Just Got Slashed.

By Noam N. Levey Updated March 5, 2025 Originally Published March 4, 2025 KFF Health News Original

The Trump administration’s first round of sweeping staff cuts to federal agencies eliminated dozens of positions at the Center for Consumer Information and Insurance Oversight, which is tasked with implementing the No Surprises Act.

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A photo illustration of a person's head with their brain drawn as tangled threads. Three hands work to unknot the threads.

Trump Team Faces Key Legal Decision That Could Put Mental Health Parity in Peril

By Aneri Pattani Updated May 13, 2025 Originally Published May 9, 2025 KFF Health News Original

The administration is facing a May 12 deadline to declare if it will defend Biden-era regulations that aim to enforce laws requiring parity in insurance coverage of mental and physical health care.

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The No Surprises Act Comes With Some Surprises

By Elisabeth Rosenthal February 14, 2024 KFF Health News Original

The No Surprises Act, the landmark law intended to protect patients from surprise out-of-network medical bills, has come with, well, some surprises. A little more than two years after it took effect, there’s good and bad news about how it’s working. First, it’s important to note that the law has successfully protected millions of patients […]

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A portrait of a woman outside her apartment.

When a Quick Telehealth Visit Yields Multiple Surprises Beyond a Big Bill

By Darius Tahir December 19, 2023 KFF Health News Original

For the patient, it was a quick and inexpensive virtual appointment. Why it cost 10 times what she expected became a mystery.

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A collage of eight photographs from Bill of the Month articles.

‘Bill of the Month’: The Series That Dissects and Slashes Medical Bills

By Elisabeth Rosenthal December 20, 2024 KFF Health News Original

Since 2018, readers and listeners sent KFF Health News-NPR’s “Bill of the Month” thousands of questionable bills. Our crowdsourced investigation paved the way for landmark legislation and highlighted cost-saving strategies for all patients.

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Emergency Physicians Decry Surprise Air-Ambulance Bills

By Molly Castle Work March 27, 2024 KFF Health News Original

Emergency room doctors say insurers are increasingly declining to cover costly air-ambulance rides for critically ill patients, claiming they aren’t medically necessary. And the National Association of EMS Physicians says the No Surprises Act, enacted in 2022, is partly to blame. The law protects patients from many out-of-network medical bills by requiring insurers and providers […]

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Readers Call on Congress to Bolster Medicare and Fix Loopholes in Health Policy

February 29, 2024 KFF Health News Original

KFF Health News gives readers a chance to comment on a recent batch of stories.

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A photo of a doctor speaking to patients in a hospital waiting room.

How Your In-Network Health Coverage Can Vanish Before You Know It

By Elisabeth Rosenthal March 15, 2024 KFF Health News Original

One of the most unfair aspects of medical insurance is this: Patients can change insurance only during end-of-year enrollment periods or at the time of “qualifying life events.” But insurers’ contracts with doctors, hospitals, and pharmaceutical companies can change abruptly at any time.

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A senior man holds a letter from a Medicare provider. He is seated a table wearing glasses and a shirt and vest

Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage

By Susan Jaffe March 29, 2024 KFF Health News Original

Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. There’s a way out.

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A photo of a woman and her husband sitting at home.

Expectant Mom Needed $15,000 Overnight to Save Her Twins

By Renuka Rayasam April 27, 2023 KFF Health News Original

Doctors rushed a pregnant woman to a surgeon who charged thousands upfront just to see her. The case reveals a gap in medical billing protections for those with rare, specialized conditions.

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KFF Health News' 'What the Health?': Arizona Turns Back the Clock on Abortion Access

April 11, 2024 Podcast

A week after the Florida Supreme Court said the state could enforce an abortion ban passed in 2023, the Arizona Supreme Court ruled that state could enforce a near-total ban passed in 1864 — over a half-century before Arizona became a state. The move further scrambled the abortion issue for Republicans and posed an immediate quandary for former President Donald Trump, who has been seeking an elusive middle ground in the polarized debate. Alice Miranda Ollstein of Politico, Rachel Cohrs Zhang of Stat, and Rachel Roubein of The Washington Post join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews KFF Health News’ Molly Castle Work, who reported and wrote the latest KFF Health News-NPR “Bill of the Month” feature, about an air-ambulance ride for an infant with RSV that his insurer deemed not medically necessary.

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A photo of Governor Gavin Newsom during a press conference taken from the side. On the wall behind him is California's state seal.

California Expands Paid Sick Days and Boosts Health Worker Wages

By Don Thompson October 25, 2023 KFF Health News Original

Gov. Gavin Newsom signed legislation expanding paid sick leave to five days, extending bereavement leave to miscarriages and failed adoptions, and approving an eventual $25-an-hour health care minimum wage. Still, in a possible sign of national ambitions, the Democrat vetoed free condoms in schools and refused to decriminalize psychedelic mushrooms.

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