Latest Morning Briefing Stories
Cómo evitar facturas médicas sorpresa… y las “trampas” de la nueva ley
Aunque una ley supuestamente protege a los pacientes de las cuentas sorpresa, también tiene grietas por donde pasa la trampa.
How to Avoid Surprise Bills — And the Pitfalls in the New Law
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.
Medicare Advantage Plans Send Pals to Seniors’ Homes for Companionship — And Profits
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.
Want Vulnerable Californians to Have Healthier Pregnancies? Doulas Say the State Must Pay Up.
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.
La medicación para prevenir el VIH debe ser gratis, pero las aseguradoras siguen cobrándola
Una norma federal estableció que los pacientes no debían pagar por la medicación para prevenir el VIH. Pero las aseguradoras siguen enviando facturas por los fármacos y servicios médicos asociados.
Seeking to Shift Costs to Medicare, More Employers Move Retirees to Advantage Plans
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.
HIV Preventive Care Is Supposed to Be Free in the US. So, Why Are Some Patients Still Paying?
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 Demise of Single-Payer in California Trips Up Efforts in Other States
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.
Plan to Fix Postal Service Shifts New Retirees to Medicare — Along With Billions in Costs
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.
Changes to Medi-Cal’s Troubled Drug Program Reduce Backlog in California, but Problems Persist
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.
KHN’s ‘What the Health?’: Contemplating a Post-‘Roe’ World
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.
Other States Keep Watchful Eye on Snags in Washington’s Pioneering Public-Option Plan
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.
An $80,000 Tab for Newborns Lays Out a Loophole in the New Law to Curb Surprise Bills
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 Takes Months to Process Medicaid Applications — Longer Than Law Allows
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.
La alta demanda de perros de servicio crea un mercado salvaje y a veces fraudulento
Estos perros aprenden a ayudar a los seres humanos, pero quedan atrapados en engaños. Muchos los usan para un mercado que abusa de los que tienen necesidades médicas.
Demand for Service Dogs Unleashes a ‘Wild West’ Market
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.
Why Millions on Medicaid Are at Risk of Losing Coverage in the Months Ahead
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.
Health Policy Valentines Too Sweet Not to Tweet
KHN highlights some of the creative valentines posted on Twitter by health policy enthusiasts.
‘Somebody Is Gonna Die’: Medi-Cal Patients Struggle to Fill Prescriptions
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.
KHN’s ‘What the Health?’: Paging the HHS Secretary
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.
