Medicare Surprise: Drug Plan Prices Touted During Open Enrollment Can Rise Within a Month
Even the savviest Medicare drug plan shoppers can get a shock when they fill prescriptions: That great deal on medications is no bargain after prices go up.
Cost Transparency
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Pharmacies Face Extra Audit Burdens That Threaten Their Existence
Pharmacy benefit managers have curtailed in-person audits of pharmacy claims during the pandemic, switching to virtual audits done by computer. That has markedly increased the number of claims they can review 鈥 and the chances for payment denials 鈥 squeezing pharmacies and bringing in more cash for the benefit companies.
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Journalists Tackle Delta Variant, Hospital Prices and Public Health Spending
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here鈥檚 a collection of their appearances.
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Hospital Prices Must Now Be Transparent. For Many Consumers, They’re Still Anyone鈥檚 Guess.
A Trump administration rule mandating that hospitals disclose true prices on their websites took effect this year. But compliance is spotty and even when the data is public, it鈥檚 hard to find and understand.
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Journalists Track Biden’s First 100 Days
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here鈥檚 a collection of their appearances.
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How Much of Trump鈥檚 Health Agenda Has Biden Undone?
In his campaign, President Joe Biden promised to undo policies, particularly health policies, implemented by former President Donald Trump. Yet, despite immense executive power, reversing four years of action takes time and resources.
By Julie Rovner -
Hospital Prices Just Got a Lot More Transparent. What Does This Mean for You?
Under a rule that kicked in Jan. 1, hospitals are required to make public the prices they negotiate with insurers. That鈥檚 a lot more information than was previously required, which was only the posting of 鈥渃hargemasters鈥 鈥 the hospital-generated list prices that few consumers or health plans actually pay.
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Surprise Federal Drug Rule Directs Insurers to Reveal What They Pay for Prescription Drugs
A provision the Trump administration tucked into its final rule on health plan price transparency requires telling consumers what they will pay out-of-pocket for drugs and showing them what the plan paid.
By Harris Meyer -
New Laws Keep Pandemic-Weary California at Forefront of Health Policy Innovation
Gov. Gavin Newsom approved many consequential health care bills by his bill-signing deadline Wednesday, including a ban on the sale of menthol and other flavored tobacco products, the creation of a state generic drug label and better coverage for mental health disorders.
By Samantha Young and Angela Hart -
Watch: Woman Hit With $28K Bill For A Throat Swab
A routine doctor's visit for a sore throat brought more than $28,000 in charges for one New York City woman in our latest "Bill of the Month" installment.
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Paying It Forward: 鈥楤ill Of The Month鈥 Series, A Vital Toolkit For Patients, Wraps Year 2
In our ongoing, crowdsourced investigation with NPR and CBS, we鈥檝e armed future health system pilgrims with the tools they need to avoid exorbitant medical bills and fight back against unfair charges. Here鈥檚 a look back at 2019鈥檚 stories.
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鈥楢n Arm And A Leg鈥: How Much For Stitches In The ER? Hard To Gauge Upfront
Consumers are admonished to be 鈥渟mart shoppers,鈥 but that鈥檚 difficult if health care prices are clear as mud. When Sarah Macsalka鈥檚 son needed stitches, she did her best to avoid the ER and still ended up with a $3,000 bill.
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KHN鈥檚 鈥榃hat The Health?鈥: The Health Care Campaign
Health care is still a top issue in the Democratic primary debate for president, but the candidates鈥 complicated plans may be doing more to confuse than to educate voters. Margot Sanger-Katz of The New York Times, Caitlin Owens of Axios and Julie Appleby of Kaiser Health News join KHN鈥檚 Julie Rovner to discuss this and more health news. Also, for extra credit, the panelists recommend their favorite health policy stories of the week.
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White House Unveils Finalized Health Care Price Transparency Rule
The final directive drew swift responses from the hospital and insurance industries. The Trump administration also released a proposed rule that would require health insurers to spell out for all services beforehand just how much patients may owe for their out-of-pocket costs.
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Podcast
KHN鈥檚 鈥榃hat The Health?鈥: Deciphering The Democrats鈥 Health Debate
Health care was a major topic at the Democratic presidential candidate debates in Detroit on Tuesday and Wednesday, but the focus on plan minutiae may have left viewers more confused than edified. Alice Ollstein of Politico, Kimberly Leonard of the Washington Examiner and Caitlin Owens of Axios join KHN鈥檚 Julie Rovner to discuss the points made by the candidates plus a series of Trump administration health initiatives on drug prices and hospital shopping.
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KHN鈥檚 鈥榃hat The Health?鈥: Dems Debate Health Care
Democratic presidential candidates disagreed on how to fix health care in their first debate Wednesday, although they all called for boosting insurance coverage and lowering prices. Meanwhile, the Trump administration is keeping health care in the news, too, with a new plan to make medical prices more available to the public. Stephanie Armour of The Wall Street Journal, Rebecca Adams of CQ Roll Call and Anna Edney of Bloomberg News join KHN鈥檚 Julie Rovner to discuss this, plus the latest in news about bipartisan progress on catch-all legislation to address 鈥渟urprise鈥 medical bills. Plus, Rovner interviews NPR鈥檚 Jon Hamilton about the latest KHN-NPR 鈥淏ill of the Month鈥 installment.
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KHN鈥檚 鈥榃hat The Health鈥: Who Will Pay To Fix Problem Of Surprise Medical Bills?
Lawmakers and patients want to eliminate 鈥渟urprise鈥 out-of-network medical bills. Hospitals, doctors and insurers say they want to eliminate them, too, but their opposition to one another鈥檚 proposals could complicate legislative efforts. Stephanie Armour of The Wall Street Journal, Alice Miranda Ollstein of Politico and Kimberly Leonard of the Washington Examiner join KHN鈥檚 Julie Rovner to discuss this, plus the latest in news about reproductive health and health care sharing ministries.
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Fixing Surprise Medical Bill Problem Shouldn鈥檛 Fall To Consumers, Panel Told
Though a range of policy solutions have been discussed by Congress, the White House and other experts, a theme of a House subcommittee hearing Tuesday was that providers and insurers are key to correcting the issue.
By Rachel Bluth -
As Hospitals Post Price Lists, Consumers Are Asked To Check Up On Them
Most hospitals appear to be complying with the federal rule to post their prices online. Yet there is little follow-up by the government or industry and debate continues about whether the price lists are creating more confusion than clarity among consumers.
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Podcast: KHN鈥檚 鈥榃hat The Health?鈥 A 鈥楬ealthy鈥 State Of The Union
Health was a featured player in President Donald Trump鈥檚 2019 State of the Union address. The president set goals to bring down prescription drug prices, end the HIV epidemic in the U.S. and cure childhood cancer, among other things. Margot Sanger-Katz of The New York Times, Anna Edney of Bloomberg News and Alice Ollstein of Politico join KHN鈥檚 Julie Rovner to discuss these issues and, for 鈥渆xtra credit,鈥 provide their favorite health policy stories of the week. Rovner also interviews KHN senior correspondent Phil Galewitz about the current 鈥淏ill of the Month鈥 feature.