Health Industry

Latest KFF Health News Stories

Whistleblower: Medicaid Managed-Care Firm Improperly Denied Care To Thousands

KFF Health News Original

An explosive report prepared by a SynerMed executive alleges the California firm, which oversaw care for 1.2 million patients, fabricated documents and violated state and federal regulations for years. The state says it left low-income patients on Medicaid managed care in “imminent danger.”

Taken For A Ride? Ambulances Stick Patients With Surprise Bills

KFF Health News Original

Public outrage over surprise medical bills prompted 21 states to pass consumer protection laws. But these laws largely ignore ambulance rides, which can leave patients stuck with hundreds or even thousands of dollars in bills.

Podcast: ‘What The Health?’ Meanwhile, In Other Health News…

KFF Health News Original

In this episode of “What the Health?” Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Alice Ollstein of Talking Points Memo and Sarah Jane Tribble of Kaiser Health News discuss some of the under-covered health stories of the past several weeks, including drug price issues, the opioid epidemic and women’s reproductive health.

Health Giant Sutter Destroys Evidence In Crucial Antitrust Case Over High Prices

KFF Health News Original

“‘Fingers crossed’ that I haven’t authorized something the FTC will hunt me down for,” a staffer wrote after destroying the documents. Sutter, a huge Northern California Health system with 24 hospitals, said it destroyed them by mistake.

Gigante de salud Sutter en demanda crucial por monopolio de sobreprecios

KFF Health News Original

De acuerdo con un juez estatal, Sutter Health, el gigante del sistema de salud que gerencia 24 hospitales en California, abusó de su poder para inflar precios y destruir documentación crítica de sus empleados.

California Fines Anthem $5 Million For Failing to Address Consumer Grievances

KFF Health News Original

The Department of Managed Health Care cited one example in which consumers and advocates had to call the insurer 22 times to contest a decision. Still, the complaint still was not resolved until the department became involved.

California Firm Running Physician Practices Is Closing Down as Scrutiny Ramps Up

KFF Health News Original

State regulators and insurers are looking into SynerMed, which medical groups depend upon to handle their finances and business operations. The groups, serving 1 million patients, fear a messy fallout.

Taking A Page From Pharma’s Playbook To Fight The Opioid Crisis

KFF Health News Original

Doctors and pharmacists in Northern California are emulating drug company sales reps with a fresh purpose in mind: They visit medical offices in the hardest-hit counties to change their peers’ prescribing habits and curtail the use of painkillers.