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Diagnosed with aggressive leukemia on a Western trip, a young man thought his insurance would cover an air ambulance ride home to North Carolina. Instead, questions about medical necessity left him with an astronomical bill.
The No Surprises Act offers protection from many surprise medical bills — but that protection may be only as good as a patient’s knowledge of the law and ability to make sure it’s enforced. Here’s what you need to know.
Many Medicare Advantage plans send caregivers to the homes of seniors periodically to help with housework and provide companionship. But the workers may also prod seniors into activities that boost the plans’ Medicare ratings and federal reimbursements.
California was supposed to start paying doulas this year to help Medicaid enrollees have healthy pregnancies. But the benefit has been delayed because doulas feel lowballed by the state’s proposed reimbursement rate, which is below what most other states pay.
Private and public employers are increasingly using the government’s Medicare Advantage program as an alternative to their existing retiree health plan and traditional Medicare coverage. As a result, the federal government is paying the “overwhelming majority” of medical costs, according to an industry analyst.
The Department of Labor issued rules in July clarifying that health plans need to cover the costs of prescription drugs proven to prevent HIV infection, along with related lab tests and medical appointments, at no cost to patients. More than half a year later, the erroneous billing continues.
The failure of single-payer health care legislation in California casts doubt on the ability of other states to pass government-run, universal health care. But activists in New York, Washington state, and elsewhere say they are taking lessons from California and changing their tactics.
After a years-long bitter partisan fight over reforming the U.S. Postal Service’s finances and service, congressional leaders say they have a compromise. The bill, which has won endorsements from both Republicans and Democrats on Capitol Hill, would force future Postal Service retirees to use Medicare as their primary source of health coverage.
After a troubled start to the new Medi-Cal prescription drug program, the state’s contractor has hired staffers to reduce wait times for medication approvals and patients seeking help. But some doctors and clinics report that patients continue to face delays.
In anticipation of the Supreme Court rolling back abortion rights this year, both Democrats and Republicans are arguing among themselves over how best to proceed to either protect or restrict the procedure. Meanwhile, millions of Americans are at risk of losing their health insurance when the federal government declares an end to the current “public health emergency.” Alice Miranda Ollstein of Politico, Shefali Luthra of The 19th, and Rachana Pradhan of KHN join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KHN’s Jay Hancock, who wrote the latest KHN-NPR “Bill of the Month” episode about a couple whose insurance company deemed their twins’ stay in intensive care not an emergency.
Washington was the first state in the U.S. to introduce a public option for health insurance, but the rollout hasn’t been smooth. Other states with public options in the works are taking notice.
The insurance company said that the birth of the Bull family’s twins was not an emergency and that NICU care was “not medically necessary.” The family’s experience with a huge bill sent to collections happened in 2020, but it exposes a hole in the new No Surprises law that took effect Jan. 1.
Missouri has more people waiting to have their Medicaid applications processed than it has approved since the expansion of the federal-state health insurance program. Although most states process Medicaid applications within a week, Missouri is taking, on average, more than two months. Patient advocates fear that means people will stay uninsured longer, leading them to postpone care or get stuck with high medical bills.
Service dogs can help people with ailments from autism to epilepsy, but a trained dog can cost up to $40,000 — and insurance won’t cover it.
KHN highlights some of the creative valentines posted on Twitter by health policy enthusiasts.
State Medicaid agencies for months have been preparing for the end of a federal mandate that has prevented states from removing people from the safety-net program during the pandemic.
Problems with California’s new Medicaid prescription drug program are preventing thousands of patients from getting their medications, including some life-saving ones. State officials say they’re working on fixes.
Health and Human Services Secretary Xavier Becerra is drawing criticism for his hands-off handling of the covid crisis even though the heads of the Centers for Disease Control and Prevention, National Institutes of Health, and FDA report to him. Meanwhile, the Department of Labor looks to enforce mental health “parity laws” that have failed to achieve their goals. Margot Sanger-Katz of The New York Times, Alice Miranda Ollstein of Politico, and Rachel Cohrs of Stat join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KHN’s Noam N. Levey, who reported and wrote the latest KHN-NPR “Bill of the Month” episode about a large emergency room bill for a small amount of medical care.
Some practitioners object to the way upfront cost estimates are designed, saying they could affect access to care and are burdensome. Other experts disagree.
Southern California correspondent Bernard J. Wolfson answers questions about the health coverage deals available on California’s Affordable Care Act marketplace during Radio Bilingüe’s news program “Línea Abierta.”
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