Latest KFF Health News Stories
Their Physical Therapy Coverage Ran Out Before They Could Walk Again
Health plans limit physical or occupational therapy sessions to as few as 20 a year, no matter the patient’s infirmities. The limits persist despite federal rules banning insurers from setting annual dollar limits on the care they will provide.
Federal Watchdog Urges Crackdown on Medicare Advantage Home Visits
Medicare officials are pushing back against a federal watchdog’s call to crack down on home visits by Medicare Advantage health plans — a practice the watchdog says may waste billions of tax dollars every year. In late October, a Health and Human Services inspector general audit found that the insurers pocketed $7.5 billion in 2023 from diagnosing health conditions that […]
The Medicare Advantage Influence Machine
New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges.
Cuando tu cobertura de salud dentro de la red… simplemente se esfuma
los contratos de las aseguradoras con médicos, hospitales y farmacéuticas (o sus intermediarios, los llamados administradores de beneficios farmacéuticos) pueden cambiar abruptamente de la noche a la mañana.
How Your In-Network Health Coverage Can Vanish Before You Know It
One of the most unfair aspects of medical insurance is this: Patients can change insurance only during end-of-year enrollment periods or at the time of “qualifying life events.” But insurers’ contracts with doctors, hospitals, and pharmaceutical companies can change abruptly at any time.
The Colonoscopies Were Free. But the ‘Surgical Trays’ Came With $600 Price Tags.
Health providers may bill however they choose — including in ways that could leave patients with unexpected bills for “free” care. Routine preventive care saddled an Illinois couple with his-and-her bills for “surgical trays.”
When a Quick Telehealth Visit Yields Multiple Surprises Beyond a Big Bill
For the patient, it was a quick and inexpensive virtual appointment. Why it cost 10 times what she expected became a mystery.
Out for Blood? For Routine Lab Work, the Hospital Billed Her $2,400
Convenient as it may be, beware of getting your blood drawn at a hospital. The cost could be much higher than at an independent lab, and your insurance might not cover it all.
Quick Genetic Test Offers Hope for Sick, Undiagnosed Kids. But Few Insurers Offer to Pay.
A new, rapid genetic test shows promise in increasing diagnoses and improving treatment for some children with rare genetic conditions. Many insurers won’t cover it, but Florida’s Medicaid program is among those that see benefits — and, potentially, savings.
Pruebas genéticas rápidas a bebés pueden salvar vidas, pero muchas aseguradoras no las cubren
Que Medicaid cubra la prueba puede expandir significativamente el acceso para los bebés; el programa de salud federal gerenciado por los estados que asegura a las familias de bajos ingresos y que cubre a más del 40% de los niños en su primer año de vida.
Journalists Discuss Abortion Lawsuits and the Pros and Cons of Health Care Sharing Plans
KFF Health News 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.
Patients Squeezed in Fight Over Who Gets to Bill for Pricey Infusion Drugs
To drive down costs, insurers are bypassing hospital system pharmacies and delivering high-priced infusion drugs, including some used in chemotherapy, via third-party pharmacies. Smarting from losing out on billing for those drugs, hospitals and clinics are trying to convince states to limit this practice, known as “white bagging.”
At Least 1.7M Americans Use Health Sharing Arrangements, Despite Lack of Protections
A new report boosts the estimated number of people enrolled in plans whose members — usually brought together by shared religious beliefs — pay one another’s health costs.
Health Care Coalition Jockeys Over Medi-Cal Spending, Eyes Ballot Initiative
California Healthline has learned that a coalition of doctors, hospitals, insurers, and community clinics want to lock in a tax on health insurance companies to draw in extra Medicaid funding. It also wants to make the tax permanent.
La decisión podría afectar los exámenes de detección sin copago y servicios preventivos similares que la mayoría de los estadounidenses con seguro tienen como parte de sus planes de salud.
Judge’s Decision Would Make Some No-Cost Cancer Screenings a Thing of the Past
A U.S. District Court ruling overturned the section of the Affordable Care Act that makes preventive health services — from colonoscopies to diabetes screenings and more — available at no cost to consumers.
KFF Health News' 'What the Health?': Judging the Abortion Pill
Any day now a conservative federal judge in Texas could upend the national abortion debate by requiring the FDA to rescind its approval of mifepristone, a drug approved in the U.S. more than 20 years ago that is now used in more than half of abortions nationwide. Meanwhile, a controversial study on masks gets a clarification, although it may be too late to change the public impression of what it found. Alice Miranda Ollstein of Politico, Jessie Hellmann of CQ Roll Call, and Sarah Karlin-Smith of the Pink Sheet join KHN chief Washington correspondent 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.
Planes de salud de Medicaid intentan proteger a sus miembros… y a sus ganancias
Estos planes, muchos administrados por titanes de los seguros, incluidos UnitedHealthcare, Centene y Aetna, han visto aumentar sus ingresos en miles de millones a medida que su membresía aumentaba en millones.
La insulina representa lo perverso del sistema sanitario estadounidense, ya que los precios de venta de este medicamento centenario, del que dependen 8,4 millones de estadounidenses para sobrevivir, se quintuplicaron en dos décadas.
Medicaid Health Plans Try to Protect Members — And Profits — During Unwinding
States are turning to the big health insurance companies to keep Medicaid enrollees insured once pandemic protections end in April. The insurers’ motive: profits.
