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Prior authorization is a common tool used by health insurers for many tests, procedures, and prescriptions. Frustrated by the process, patients and doctors have turned to social media to publicly shame insurance companies and elevate their denials for further review.
A Tulsa-based gas station chain is using its knowledge of how to serve customers and locate shops in easy-to-find spots to enter the urgent care industry, which has doubled in size over the past decade. Experts question how the explosion of convenient clinics will affect care costs and wait times.
Federal officials are trying to clamp down on private arrangements among some hospitals to pay themselves back for the Medicaid taxes they’ve paid. State health officials and the influential hospital industry argue that regulators have no jurisdiction over the agreements.
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.
Clinics serving Alzheimer’s patients are working out the details of who will get treated with the new drug Leqembi. It won’t be for everyone with memory-loss symptoms.
The new Montana law contains a couple of significant differences from the measure voters rebuffed last fall.
Patient advocates are tackling the “overwhelming task” of connecting people with health insurance as millions lose coverage due to the end of pandemic protections on Medicaid eligibility.
The military first documented health concerns surrounding chemicals known as PFAS decades ago yet has continued to use firefighting foam made with them. Despite scores of lawsuits by its personnel and high rates of testicular cancer among troops, it has been slow to investigate a connection.
From the front lines of Wisconsin’s abortion battle, obstetricians describe patients who cannot comprehend having to carry nonviable pregnancies. And only one pharmacist in town can be found who will fill prescriptions for abortion pills.
Although nearly 40% of Americans 60 and older are obese, Medicare doesn’t cover weight loss medications. Meanwhile, studies haven’t thoroughly examined new drugs’ impact on older adults.
As three years of pandemic stress accelerated an ongoing nationwide mental health crisis, peer respite programs diverted patients from overburdened emergency rooms, psychiatric institutions, and behavioral therapists. Now, more “respites” are opening.
A proposed Environmental Protection Agency rule calls for companies to disclose PFAS manufactured or imported since 2011. The chemical industry is upset because such compliance would cost an estimated $1 billion, while environmental health advocates worry because the rule wouldn’t ban the chemicals outright.
As settlement dollars land at the state level, state councils wield significant power in determining how the windfall gets spent. And, though they will likely include the most knowledgeable voices on addiction, these panels also face concerns about conflicts of interest and other issues.
To drive down costs, insurers are bypassing hospital system pharmacies and delivering high-priced infusion drugs, including some used in chemotherapy, via third-party pharmacies. Smarting from losing out on billing for those drugs, hospitals and clinics are trying to convince states to limit this practice, known as "white bagging."
Distrust of public health authorities, who say drinking raw milk is dangerous, fuels demand for unpasteurized milk products, leaders on both sides of the issue say.
The first FDA-authorized cigarettes with 95% less nicotine than traditional smokes will go on sale in California, Florida, and Texas starting in early July. Anti-smoking groups oppose greenlighting just one plant biotech’s products and instead urge federal regulators to set a low-nicotine standard for the entire industry.
Last month, Florida joined a growing number of states in banning sales taxes on diapers to make them more affordable for older adults and families with young children. Though diapers are essential for many, they are not covered by food stamps. Nor are incontinence products for older adults typically covered by Medicare. The cost can easily add up on a fixed income.
The “front door” to the health system is changing, under pressure from increased demand, consolidation, and changing patient expectations.
Supporters say the proposed rules would balance the goals of increasing access to health care and helping prevent medication misuse. Opponents say the rules would make it difficult for some patients — especially those in rural areas — to get care.
Physicians and attorneys say it’s a question of when — not if — a pregnant person dies from lack of care in a state with an abortion ban, potentially setting the stage for a malpractice lawsuit that could pressure providers to reconsider delaying or denying care.
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