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Colorado鈥檚 new Prescription Drug Affordability Board could cap what health plans and consumers pay for certain medications starting next year. The process will pit patient groups against one another.
After local leaders in rural Nevada reached an impasse over a proposed Planned Parenthood clinic, an anti-abortion activist pitching local abortion bans across the U.S. arrived at their remote City Hall.
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鈥 Medicare information to improperly bill the federal government 鈥 and could do it again, say federal investigators.
At least eight states have implemented or are considering limits on what patients can be billed for the use of a hospital鈥檚 facilities even without having stepped foot in the building.
Pharmaceutical companies have put the brakes on many states鈥 ability to execute prisoners using lethal injections. Lacking alternatives, states are trying to keep the public from learning details about how they carry out executions.
Spending the money effectively and equitably is a tall order for state and local governments, and a lack of transparency in the process is already leading to fears of misuse.
Lawmakers are considering creating standards to set Medicaid reimbursement rates. But industry observers wonder whether the move would be too little, too late to bolster a beleaguered industry.
When Medicare stops paying for a pricey drug that prolongs life, an Ohio man considers giving up treatment to spare his family enormous debt.
Facing rare scrutiny from federal auditors, some Medicare Advantage health plans failed to produce any records to justify their payments, government records show. The audits revealed millions of dollars in overcharges to Medicare over three years.
Only a sliver of the funding given to state, local, and tribal governments through the American Rescue Plan Act has been steered to mental health nationwide, but mental health advocates and clinicians hope the money it provides will help address gaps in care for children. In Appalachian Ohio, the funding is helping expand services.
The cash represents an unprecedented opportunity to derail the opioid epidemic, but with countless groups advocating for their share of the pie, the impact could depend heavily on geography and politics.
In August, Congress approved a $35 cap on what seniors will pay for insulin, but that change came too late to add to the online tool that helps Medicare beneficiaries compare dozens of drug and medical plans. Federal officials say beneficiaries who use insulin will have the opportunity to switch plans after open enrollment ends Dec. 7.
As the covid-19 pandemic raged, an independent nonprofit tied to the Centers for Disease Control and Prevention hired an army of seasoned professionals to fill the gaps in the country鈥檚 public health system. Now, the money has largely run out, and state and local health departments are again without their expertise.
Although control of Congress was still undecided Wednesday, Republicans seemed poised to take power in the House, while the fate of the Senate remained too close to call. Economic issues were at the top of voters鈥 minds, but abortion access also played a large role in their decisions.
Women who need abortion care come to Michigan from surrounding states that already have banned the procedure. A clinic in suburban Detroit allowed a reporter to interview patients, doctors, and nurses to understand what is at stake as voters decide whether to guarantee abortion access in the Michigan Constitution.
Centene, the largest Medicaid managed-care company in the U.S., has thrown more than $26.9 million at political campaigns across the country since 2015, especially focused on states where it is wooing Medicaid contracts and settling accusations that it overbilled taxpayers. Among its tactics: Centene is skirting contribution limits by giving to candidates through its many subsidiaries.
The cheaper over-the-counter aids are for adults with mild to moderate hearing loss 鈥 a market of tens of millions of people, many of whom have until now been priced out because prescription devices can cost thousands of dollars.
Congress won鈥檛 be back in Washington until after Election Day, but lawmakers have left themselves a long list of items to finish up in November and December, including unfinished health care policies. Sandhya Raman of CQ Roll Call; Jessie Hellmann, also of CQ Roll Call; and Mary Agnes Carey of KHN join KHN鈥檚 Julie Rovner to discuss these topics and more. Also this week, Rovner interviews KHN鈥檚 Sam Whitehead, who reported and wrote the latest KHN-NPR 鈥淏ill of the Month鈥 episode about a family who tried to use urgent care to save money, but ended up with a big emergency room bill anyway.
Texas is at least the 12th state to settle with St. Louis-based Centene Corp. over allegations that it overcharged Medicaid prescription drug programs.
After a unanimous ruling from the high court, doctors who are accused of writing irresponsible prescriptions can go to trial with a new defense: It wasn鈥檛 on purpose.
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