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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.

Texas Clinics Busting Traditional Silos Of Mental And Physical Health Care

By Caroline Covington July 5, 2018 KFF Health News Original

Efforts to provide care that integrates physical and mental health services are spreading, partly because untreated mental health conditions negatively affect physical health and escalate health care costs.

What Happens If You’re Forced To Switch Health Plans When You’re Sick?

By Pauline Bartolone August 25, 2017 KFF Health News Original

State lawmakers in California have an answer: legislation that would require your new insurer to keep paying for your current doctors even if they’re not in the network.

Pfizer Settles Kickback Case Related To Copay Assistance For $24M

By Sydney Lupkin May 24, 2018 KFF Health News Original

The drugmaker agreed to a settlement with the Justice Department over allegations that it funneled copay assistance money through a foundation to Medicare patients.

When Erratic Teenage Behavior Means Something More

By Emily Bazar June 13, 2018 KFF Health News Original

Teenagers can be volatile and moody, but there are some specific signs that separate typical adolescent behavior from potentially serious mental health problems.

Trump Vows (Again) To Lower Drug Prices But Skeptics Doubt Much Will Change

By Sarah Jane Tribble and Liz Szabo May 11, 2018 KFF Health News Original

President Donald Trump’s much-awaited speech about slashing drug costs was long on rhetoric but short on specifics that will reduce prices.

The Training Of Dr. Robot: Data Wave Hits Medical Care

By John McQuaid February 14, 2018 KFF Health News Original

Algorithms and other technologies are moving from research labs to hospitals and clinics to predict and combat disease.

Doling Out Pain Pills Post-Surgery: An Ingrown Toenail Not The Same As A Bypass

By Julie Appleby June 22, 2018 KFF Health News Original

As the opioid epidemic rages, a Johns Hopkins surgeon and researcher is leading an effort to curb overprescribing by offering procedure-specific guidelines to ensure that post-surgical patients leave the hospital with enough, but not too much, pain medication.

Hoping To See Your Doctor Via Telemedicine? Here’s A Quick Guide.

By Steven Findlay May 9, 2018 KFF Health News Original

All private health plans, Medicare, state Medicaid programs and the VA now cover some e-visits — albeit with restrictions.

Lax Oversight Leaves Surgery Center Regulators And Patients In The Dark

By Christina Jewett and Mark Alesia, USA Today Network August 9, 2018 KFF Health News Original

A Kaiser Health News and USA Today Network investigation finds that a hodgepodge of state rules governing outpatient centers allow some deaths and serious injuries to go unexamined. And no rule stops a doctor exiled by a hospital for misconduct from opening a surgery center down the street.

Large Mass. Health Care System Drops Out Of Networks Being Planned For Medicaid

August 18, 2017 Morning Briefing

UMass Memorial Health Care said it will continue to care for MassHealth patients but it won’t join in the accountable care organizations being formed as the state revamps Medicaid. Meanwhile, a California health care system is moving some of its Medicaid patients to clinics instead, and Utah formally submits a request to the federal government for a limited Medicaid expansion for some homeless people.

A Baby Was Treated With A Nap And A Bottle Of Formula. The Bill Was $18,000.

By Jenny Gold and Sarah Kliff, Vox July 2, 2018 KFF Health News Original

An ER patient can be charged thousands of dollars in “trauma fees” — even if they weren’t treated for trauma.

How Many Opioid Overdoses Are Suicides?

By Martha Bebinger, WBUR March 28, 2018 KFF Health News Original

Opioid overdoses and related deaths are still climbing, U.S. statistics show. Teasing out which overdoses are intentional can be hard, but is important for treatment, doctors say.

Medicare Advantage Plans Cleared To Go Beyond Medical Coverage — Even Groceries

By Susan Jaffe April 3, 2018 KFF Health News Original

Under new federal rules unveiled this week, these privately run alternatives to traditional Medicare might provide air conditioners, rides to medical appointments and home-delivered meals.

Listen: How A ‘Hippie Clinic’ In San Francisco Inspired A Medical Philosophy

By Carrie Feibel, KQED January 10, 2018 KFF Health News Original

The Haight Ashbury Free Clinic still serves people living on the fringes in San Francisco. This radio story recounts its 51-year history.

Community Health Centers Caught In ‘Washington’s Political Dysfunction’

By Steven Findlay February 5, 2018 KFF Health News Original

The centers, which serve 27 million people, get about 20 percent of their funding from the federal government. But that revenue is slated to end on March 31.

Lifting Therapy Caps Is A Load Off Medicare Patients’ Shoulders

By Susan Jaffe March 14, 2018 KFF Health News Original

Last month’s budget deal means Medicare beneficiaries are eligible for physical and occupational therapy indefinitely. Plus, prescription drug costs will fall for more seniors.

Study Finds Significant Differences In Plans Sold On Or Off The Exchanges

By Michelle Andrews October 28, 2016 KFF Health News Original

Researchers at the Robert Wood Johnson Foundation found more bronze and gold offerings off the exchange and better out-of-network options. But there are no subsidies.

A Tale Of Two CT Scanners — One Richer, One Poorer

By Alison Kodjak, NPR News April 9, 2018 KFF Health News Original

Why is the price of a CT scan 33 times higher in an hospital emergency room than in an outpatient imaging center just down the street?

Churning, Confusion And Disruption — The Dark Side Of Marketplace Coverage

By Jay Hancock December 7, 2017 KFF Health News Original

The Affordable Care Act has increased the number of people with insurance, but shopping around for plans puts a burden on patients, especially this year.

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