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Pharmacy benefit managers have curtailed in-person audits of pharmacy claims during the pandemic, switching to virtual audits done by computer. That has markedly increased the number of claims they can review — and the chances for payment denials — squeezing pharmacies and bringing in more cash for the benefit companies.
Each year, hundreds of thousands of new mothers lose Medicaid coverage after 60 days when their income exceeds limits. But deadly childbirth complications persist months longer.
A significant number of post-covid patients suffer from syndromes that few doctors understand.
No-shows for behavioral health appointments have been a long-standing problem, with up to 60% skipped. Now telehealth, fueled by the pandemic, makes it easier for people dealing with depression and other mental health issues to make it to their appointments at a time when such care is in high demand. But teletherapy creates other challenges.
With schools opening up classrooms, millions of young athletes are also getting out on fields and courts. But pandemic precautions and delays are spurring conflicts among parents, coaches and doctors.
Grappling with stagnant pay and a lack of personal protective equipment, firefighters are even more frustrated to find they are lower down the vaccine priority list than health care workers despite serving on the front lines of the medical system.
People with intellectual and developmental disabilities are more likely to have medical conditions that make covid especially dangerous. But a lack of federal tracking means no one knows how many people in disability group housing have fallen ill or died from the virus.
The wealthy corporation that owns Chicago’s Mercy Hospital says it must close the hospital because it’s losing money. A government board says no. The corporation still has the upper hand.
As the pandemic hits Latino communities especially hard, Illinois is expanding public health insurance to all low-income noncitizen seniors. Advocates hope other states follow its lead.
During the pandemic, shelters are having to change the way they do things to prevent the virus from spreading among the vulnerable homeless population. Now, as winter weather moves in, there’s less room at the shelters for those in need — threatening to leave many, literally, out in the cold.
Rural hospitals have been closing at a quickening pace in recent years, but a number of inner-city hospitals now face a similar fate. Experts fear that the economic damage inflicted by the COVID pandemic is helping push some of these urban hospitals over the edge at the very time their services are most needed.
A KHN review found more than 20 states either don’t count or have incomplete data on the use of COVID-19 antigen tests, leaving the public in the dark about the true scope of the pandemic.
2020 will be a year like no other on college campuses, as every institution makes its own rules. Some have no plans to routinely test students for the coronavirus; others aim to test every student and staff member twice a week.
The coronavirus has forced drug rehabilitation centers to scale back operations or temporarily close, leaving people who have another potentially deadly disease — addiction — with fewer opportunities for help.
As more and more people drift back into their workplaces, they face a very small space that can create a large logjam: the elevator.
“The awful truth is families have no control over what’s happening,” one advocate says.
Illinois is moving thousands of children into its Medicaid managed-care program. Proponents say the approach can cut costs while increasing access to care. But after a phase-one rollout of the new health plans caused thousands to temporarily lose coverage, some question whether it’s the right move.
State and city officials are using a dose of humor to urge residents to stay home in the serious mission of controlling COVID-19.
Doctors specialize in the science of healing, but tattoo artist Eric Catalano specializes in the art of it. The single father of three does up to eight reconstructive medical tattoos for free each “Wellness Wednesday” in his small Illinois shop, drawing in nails on finger amputees, mocking up belly buttons after tummy tucks and fleshing out lips on a woman mauled by a dog.
Corner stores that provide groceries for those using the federal food stamp program have become magnets for violence just outside St. Louis. Gunshots ring out under the cover of darkness, windows are postered over, and the quality of food doesn’t make a trip to the corner store worth the risk. Now local residents are putting their feet down.
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