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The ranks of community-based behavioral health providers in Montana have diminished amid rising costs, greater need, and stagnant Medicaid reimbursement rates. Now, as state lawmakers debate solutions, providers are hoping just to cover their costs.
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here’s a collection of their appearances.
The state wants to stop paying Kaiser Permanente for treating severely mentally ill Medi-Cal patients in Sacramento and Solano counties and force the counties to take on the task. The counties’ leaders say they can’t afford it.
The federal government wants to change the way health insurers use prior authorization — the requirement that patients get permission before undergoing treatment. Designed to prevent doctors from deploying expensive, ineffectual procedures, prior authorization has become a confusing maze that denies or delays care, burdens physicians with paperwork, and perpetuates racial disparities. New rules may not be enough to solve the problems.
States are turning to the big health insurance companies to keep Medicaid enrollees insured once pandemic protections end in April. The insurers’ motive: profits.
Big Pharma may be moving on from squeezing diabetes patients on insulin prices, but it’s the arbitrators that jack up prices for those who can least afford them.
President Joe Biden and Republicans in Congress spent last month sparring over whether to shield Medicare and Social Security from budget cuts — leading some to wonder if Medicaid was on the table instead. Biden and Democrats say no, but some Republicans seem eager to trim federal spending on the health program for Americans with low incomes. And ready or not, artificial intelligence is coming to medical care. Benefits, as well as unintended consequences, are likely. Alice Miranda Ollstein of Politico, Rachel Cohrs of STAT News, and Lauren Weber of The Washington Post join KHN’s chief Washington correspondent, Julie Rovner, to discuss these issues and more.
States take drastically different approaches to recovering Medicaid money from deceased participants’ estates. Demands for repayment of Medicaid spending can drain the assets a person leaves behind, depending on where they lived.
Medi-Cal serves more than one-third of the state’s population — offering a dizzying range of care to a diverse population. In the new “Faces of Medi-Cal” series, California Healthline will assess the program’s strengths and weaknesses through the lives and experiences of its enrollees.
The removals, detailed in emails between state and federal health officials, hinged on disagreements over how states could disenroll people during the public health emergency. Consumer advocates fear the alleged violation signals the mess to come on April 1, when the pandemic-era Medicaid coverage mandate ends.
As many lower-income Americans prepare to lose pandemic-era access to Medicaid, President Joe Biden vowed to stop Republicans from making deeper cuts to lower the national debt. Other changes may still be up for discussion.
Billing experts and lawmakers are playing catch-up as providers find ways to get around new surprise-billing laws, leaving patients like Danielle Laskey of Washington state with big bills for emergency care.
Nearly half a million Californians without legal residency make too much to qualify for Medicaid yet they can’t afford to buy coverage. A state lawmaker is proposing to open up the state’s health insurance exchange as a first step to providing them affordable insurance.
KHN gives readers a chance to comment on a recent batch of stories.
Patients who depend upon special drugs to treat rare diseases are caught in the crossfire as drugmakers and the FDA battle over regulations that reward companies for developing treatments for relatively small pools of patients.
CMS advanced two proposed changes that could affect Medicare Advantage plans. One would allow the government to recover past overpayments. As a result, it could reduce those insurers’ profits, leading them to increase enrollees' out-of-pocket costs or reduce benefits. But it's inaccurate to characterize the changes as "cuts."
The first installment of InvestigateTV and KHN’s “Costly Care” series explores one California mother’s experience struggling to get reimbursed for midwifery care and the differences between providers that may determine whether insurance covers them.
Insurers, employers, and taxpayers will all be affected as drug manufacturers move these products to the commercial market.
President Joe Biden’s 2023 State of the Union address leaned heavily on health care issues. Biden took a victory lap for recent accomplishments like capping prescription drug costs for seniors on Medicare. He also urged Congress to make permanent the boosted premium subsidies under the Affordable Care Act, and he sparred with Republicans on threats to cut Social Security and Medicare. Also this week, both sides in the abortion debate are bracing for a court decision out of Texas that could, at least temporarily, make the abortion pill mifepristone illegal nationwide. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Sarah Karlin-Smith of the Pink Sheet join KHN chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Kate Baicker of the University of Chicago about a possible middle ground in the effort to get universal health insurance coverage.
The nation’s largest Medicaid insurer denies wrongdoing after the California attorney general’s office investigated it for inflating prescription drug costs.
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