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The Department of Health and Human Services is tasked with monitoring denials both by Obamacare health plans and those offered through employers and insurers. As insurers’ denials become more common, they sometimes defy not just medical standards of care but sheer logic. Why hasn’t the agency fulfilled its assignment?
After emergency surgery, an American expatriate with Swiss insurance now carries the baggage of a five-figure bill. Costs for medical care in the U.S. can be two to three times the rates in other developed countries, so foreigners and expats with good insurance in their home countries need travel insurance to protect themselves from “crazy prices.”
Thousands of South Dakotans are being knocked off Medicaid, only to be eligible to requalify several months later. Even more enrollees are likely to experience a temporary loss of coverage in North Carolina.
Before the covid-19 public health emergency ended, Medicare advocates around the country noticed a rise in complaints from beneficiaries who received at-home covid tests they never requested. Bad actors may have used seniors’ Medicare information to improperly bill the federal government — and could do it again, say federal investigators.
The public health emergency declaration for covid-19 ends May 11, ushering in major changes in how Americans can access and pay for the vaccines, treatments, and tests particular to the culprit coronavirus. But not everyone will experience the same changes, creating a confusing patchwork of coverage — not unlike health coverage for other diseases. Meanwhile, outside advisers to the FDA formally recommended allowing a birth control pill to be sold without a prescription. If the FDA follows the recommendation, it would represent the first over-the-counter form of hormonal contraception. Margot Sanger-Katz of The New York Times, Tami Luhby of CNN, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico join KFF Health News’ Julie Rovner to discuss these issues and more. Plus for “extra credit” the panelists suggest health policy stories they read this week they think you should read, too.
What should you do when your search for an in-network mental health care provider comes up empty? Abigail Burman has some expertise to share.
California’s safety-net health program has resumed annual eligibility checks after three years, which means beneficiaries will need to provide updated personal information to maintain coverage. Here’s what to watch for.
The recently ended legislative session was marked by Medicaid reimbursement hikes, abortion restrictions, anti-LGBTQ+ statutes, behavioral health spending, and workforce and insurance measures.
A warning from the Treasury Department that the U.S. could default on its debt as soon as June 1 has galvanized lawmakers to intervene. But there is still no obvious way to reconcile Republican demands to slash federal spending with President Joe Biden’s demand to raise the debt ceiling and save the spending fight for a later date. Meanwhile, efforts to pass abortion bans in conservative states are starting to stall as some Republicans rebel against the most severe bans. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Rachel Cohrs of Stat, and Alice Miranda Ollstein of Politico join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and more.
A Medi-Cal patient illustrates how early schizophrenia treatments can yield big benefits. Advocates want California to expand such services to more people living with severe mental illness, which they argue will not only improve lives but also save money over time.
Young cancer patients must act quickly to preserve their sperm and eggs once they get their diagnosis, and many can’t afford the cost.
KFF Health News gives readers a chance to comment on a recent batch of stories.
Doctors rushed a pregnant woman to a surgeon who charged thousands upfront just to see her. The case reveals a gap in medical billing protections for those with rare, specialized conditions.
The Supreme Court is considering the future of the abortion pill mifepristone, after GenBioPro sued the FDA over limitations that effectively block generic production of the drug, a major part of the market. Congress is considering proposals that would impose Medicaid work requirements, crack down on pharmacy benefit managers, and more. And President Joe Biden moved to expand health coverage to young immigrants known as “Dreamers.” Rachel Cohrs of Stat, Sandhya Raman of CQ Roll Call, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico join KFF Health News’ Mary Agnes Carey to discuss these issues and more.
The private equity-backed practice has been known to demand more than $100,000 in charges or penalties. One patient is fighting back.
Lisa French was told her surgery would cost $1,337. But the hospital sent her a bill for $229,000, then sued her. The case went all the way to the Colorado Supreme Court. The court’s ruling could have major implications for determining a “reasonable price” in health care.
A growing number of states — including Maryland, Colorado, and Massachusetts — are using tax forms to point people toward lower-cost health coverage available through state insurance marketplaces.
When uninsured people are diagnosed with cancer, accessing resources and paying for treatment can be daunting. The safety nets meant to help often fall short, say cancer physicians and health policy experts who study access to care. Some patients find it easier to play the odds.
Georgia is among 35-plus states that have used an under-the-radar federal funding mechanism to boost payments for hospitals and other providers under Medicaid. But a government watchdog and a congressional advisory commission say sparse oversight makes it hard to tell if the “directed payments” program is meeting its goals.
Montana is one of several states considering expanding coverage of continuous glucose monitors, but insurance companies and some providers argue that not all people with diabetes need them.
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