Time to Say Goodbye to Some Insurersā Waivers for Covid Treatment Fees
Insurers voluntarily set the charges aside earlier in the pandemic ā but that means those same health plans can decide to reinstate them.
Medicare
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Humana Health Plan Overcharged Medicare by Nearly $200 Million, Federal Audit Finds
Medicare Advantage company may face record penalty over alleged billing errors.
By Fred Schulte -
KHNās āWhat the Health?ā: Pause and Effect on Covid Vaccines
Podcast panelists discuss a range of health policy developments, from the latest in the covid vaccination effort to the HHS budget, among other things.
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KHNās āWhat the Health?ā: Planning for Round Two
The ink is barely dry on the recent covid relief bill, but Democrats in Congress and President Joe Biden are wasting no time gearing up for their next big legislative package. Meanwhile, predictions of more states expanding Medicaid have proved premature. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat and Kimberly Leonard of Business Insider join KHNās Julie Rovner to discuss these issues and more. Plus, Rovner interviews KHNās Lauren Weber, who reported the latest KHN-NPR āBill of the Monthā episode.
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Democrats Gave Americans a Big Boost Buying Health Insurance. It Didnāt Come Cheap.
The $1.9 trillion covid relief bill expands subsidies for private insurance plans. That will lighten the burden on consumers, but it locks taxpayers into yet more support for the health care industry.
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Under New Cost-Cutting Medicare Rule, Same Surgery, Same Place, Different Bill
A Trump administration Medicare rule will push some hospital patients into a Catch-22: The government says several hundred procedures no longer need to be done in a hospital, but it did not approve them to be performed elsewhere. So patients will still need to use a hospital while not officially admitted ā and may be charged more out-of-pocket for the care.
By Susan Jaffe -
Democrats Eye Medicare Negotiations to Lower Drug Prices
Progressive and conservative Democratic lawmakers, as well as President Joe Biden, are in favor of authorizing federal officials to negotiate with drugmakers over what Medicare pays for at least some of the most expensive brand-name drugs and to base those prices on the drugsā clinical benefits. Such a measure could put Republicans in the uncomfortable position of opposing an idea that most voters from both parties generally support.
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Countless Homebound Patients Still Wait for Covid Vaccine Despite Seniorsā Priority
Health organizations have begun sending doctors and nurses to apartment buildings and private homes to vaccinate homebound seniors, but the efforts are slow and spotty.
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Medicare Cuts Payment to 774 Hospitals Over Patient Complications
Renowned medical centers are among the quarter of general hospitals that will lose 1% of Medicare payments for one year because their patients have high rates of bedsores, sepsis and other preventable complications.
By Jordan Rau -
Montanaās Health Policy MVP Takes Her Playbook on the Road
Marilyn Bartlett, credited with saving Montanaās state employee health plan millions of dollars, is a busy consultant now, as states, counties and big businesses try to use her playbook to bring down hospital costs.
By Dan Gorenstein and Leslie Walker -
4 Vital Health Issues ā Not Tied to Covid ā That Congress Addressed in Massive Spending Bill
Lawmakers answered pleas from strained health facilities in rural areas, agreed to cover the cost of training more new doctors, sought to strengthen efforts to equalize mental health coverage with that of physical medicine and instructed the federal government to collect data that could be used to rein in high medical bills.
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Trumpās Pardons Included Health Care Execs Behind Massive Frauds
Those walking away free were facing years in prison for crimes of āunbounded greed.ā
By Fred Schulte -
After a Decade of Lobbying, ALS Patients Gain Faster Access to Disability Payments
In late December, then-President Donald Trump signed a law that eliminates ā only for people with Lou Gehrigās disease ā the required five-month waiting period before benefits begin under the Social Security Disability Insurance program. Gaining SSDI also gives these patients immediate Medicare health coverage.
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One Ambulance Ride Leads to Another When Packed Hospitals Cannot Handle Non-Covid Patients
A Kansas woman thought sheād find help at her local emergency room. What she found instead was a packed hospital and an ambulance ride to someplace else.
By Sandy West -
Illinois Is First in the Nation to Extend Health Coverage to Undocumented Seniors
As the pandemic hits Latino communities especially hard, Illinois is expanding public health insurance to all low-income noncitizen seniors. Advocates hope other states follow its lead.
By Giles Bruce -
Many Health Plans Now Must Cover Full Cost of Expensive HIV Prevention Drugs
Most private insurance will be required to cover drugs, like Truvada, that offer protection against HIV infection, without making plan members share the cost.
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Seniors Face Crushing Drug Costs as Congress Stalls on Capping Medicare Out-Of-Pockets
While many private insurers cap what members pay in health costs, Medicare does not. Democrats and Republicans in Congress have proposed annual limits ranging from $2,000 to $3,100. But thereās disagreement about how to pay for that cost cap.
By Harris Meyer -
KHNās āWhat the Health?ā: 2020 in Review ā It Wasnāt All COVID
The coronavirus pandemic colored just about everything in 2020. But there was other health policy news that you either never heard or might have forgotten about: the Affordable Care Act going before the Supreme Court with its survival on the line; ditto for Medicaid work requirements. And a surprise ending to the āsurprise billā saga. Joanne Kenen of Politico, Anna Edney of Bloomberg News and Sarah Karlin-Smith of Pink Sheet join KHNās Julie Rovner to discuss these issues and more.
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Medicare Open Enrollment Is Complicated. Hereās How to Get Good Advice.
Itās a complex program with many options ā as well as confusing rules and nuances. Hereās how to get reliable guidance.
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Patients Struggle to Find Prescription Opioids After NY Tax Drives Out Suppliers
The tax was touted as a way to generate funding for treatment programs across the state. But to avoid paying, scores of manufacturers and wholesalers stopped selling opioids in New York.