‘Dark Money’ Group Angles for Higher Medicare Advantage Payments
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Health Industry
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Medicare Advantage ‘Dark Money’ Group Attempts To Win Higher Payments for Insurance Companies
Medicare Advantage insurers say a proposal by the Trump administration to keep their payments nearly flat next year may lead to service cuts that harm seniors struggling to afford health care. A decision is due by early next month.
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Families Scramble To Pay Five-Figure Bills as Clock Ticks on Promised Preauthorization Reforms
Last summer, the Trump administration announced a voluntary pledge by health insurers to reform prior authorization, which often requires patients or their doctors to seek preapproval from insurers before proceeding with medical care. Patient advocates and medical providers remain skeptical.
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Primary Care Is in Trouble. So Doctors Band Together To Boost Their Market Power.
Thousands of primary care practices are fighting to remain financially viable and independent. Many are banding together to form Independent Physician Associations, or IPAs, to increase their market power.
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Cosmetic Surgery Investigation Prompts Warnings for Patients, and a Push for Tighter Safety Standards
A national plastic surgeons group is warning people to “do their homework” before having liposuctions, Brazilian butt lifts, or other cosmetic procedures after an investigation into cosmetic surgery chains by KFF Health News and NBC News.
By Fred Schulte -
Florida Hasn’t Expanded Medicaid. Lawmakers Want To Add Work Requirements Anyway.
Florida is not mandated to add work requirements for Medicaid, because the state has not expanded eligibility to more low-income adults. But lawmakers have proposed requiring some adults in the state’s program to work anyway, a policy that could leave many uninsured.
By Daniel Chang -
The NIH Workforce Is Its Smallest in Decades. Here’s the Work Left Behind.
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By Rachana Pradhan and Katheryn Houghton -
The People — And Research — Lost in the NIH Exodus
Government data shows the National Institutes of Health lost about 4,400 people — more than 20% of its staff — as the Trump administration slashed the federal workforce. Hear from six scientists on why they walked out the door and the work they left behind.
By Rachana Pradhan and Katheryn Houghton -
Six Federal Scientists Run Out by Trump Talk About the Work Left Undone
Cancer treatments, disease outbreaks, addiction science: Scientists say an exodus from the National Institutes of Health will harm the nation's ability to respond to illness.
By Rachana Pradhan and Katheryn Houghton 40 Years of Health Policy
Episode 436This month is 40 years since host Julie Rovner, chief Washington correspondent for KFF Health News, began reporting on health policy in Washington. To mark the anniversary, Rovner is joined by two longtime sources to discuss what has — and has not — changed since 1986.
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Lawmakers, Health Groups Resist Their States’ Rural Health Fund Plans
Some Republican state lawmakers and state health associations are pushing back against spending plans under the Trump administration’s $50 billion federal rural health fund. Federal administrators already approved states’ plans, but in many cases, state lawmakers must greenlight spending.
By Arielle Zionts and Sarah Jane Tribble -
Despite Their Successes, Some Mobile Crisis Response Teams Are in Crisis
Mobile crisis units are trained to respond to emergency calls when people are experiencing delusions or hallucinations. But unlike police departments, which are generally funded by local taxpayers, mobile crisis teams don’t have a single, reliable funding source. As a result, some are closing down, despite successful operations and local support.
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Medicaid Is Paying for More Dental Care. GOP Cuts Threaten To Reverse the Trend.
More than three dozen states cover dental services for low-income and disabled individuals on Medicaid, in recognition of such care’s importance to overall health. But with about $900 billion in funding cuts expected to hit states over the next decade, many programs could roll back dental coverage.
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A Canadian Hospital Scoops Up Nurses Who No Longer Feel Safe in Trump’s America
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By Brett Kelman -
To Avoid Care Disruptions, Know When the Clock Runs Out on Your Prior Authorization
A Massachusetts woman knew the medicine her doctor prescribed required preauthorization, but she didn’t realize the approval had an expiration date. It took nearly three weeks of phone calls and paperwork to get her prescription refilled.
By Sarah Boden -
He Needs an Expensive Drug. A Copay Card Helped — Until It Didn’t.
Diagnosed with an autoimmune disorder, a California man was prescribed a drug that costs thousands of dollars a month. He said he was reassured that the drugmaker’s copay card would cover his share, but after two months, the card was empty.
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‘Kind of Morbid’: Health Premiums Threaten Their Nest Egg. A Terminal Diagnosis May Spare It.
Chaz and Jean Franklin were facing a sevenfold increase in their health premium payments with the expiration of enhanced federal subsidies for Affordable Care Act plans at the end of 2025. Then Jean received a crushing diagnosis that will claim her life but save the couple money.
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‘You Aren’t Trapped’: Hundreds of US Nurses Choose Canada Over Trump’s America
More than 1,000 American nurses have successfully applied for licensure in British Columbia since April, a massive increase over prior years. Ontario and Alberta have also seen more interest from Americans.
By Brett Kelman -
As More Americans Embrace Anxiety Treatment, MAHA Derides Medications
Robert F. Kennedy Jr. has criticized the broadening use of anxiety medications, claiming they’re harmful. Doctors and researchers say the MAHA movement is misrepresenting drugs that have been proved to safely treat chronic anxiety and point to broader social changes to explain their increased use.
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State Lawmakers Seek Restraints on Wage Garnishment for Medical Debt
At least eight states are considering legislation to curtail wage garnishment over unpaid medical bills, as health care costs rise and more people become underinsured.