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The laws governing Medicare don鈥檛 provide coverage for self-administered diagnostic tests, which is precisely what the rapid antigen tests are and why they are an important tool for containing the pandemic.
A St. Louis-area toddler burned his hand on the stove, and his mom took him to the ER on the advice of her pediatrician. He wasn鈥檛 seen by a doctor, and the dressing on the wound wasn鈥檛 changed. The bill was more than a thousand dollars.
Telling insurance companies to pay for rapid covid-19 tests is just the latest covid-related cost the federal government expects them to bear. But who really ends up paying for it?
The Department of Health and Human Services issued preliminary rules regarding health insurance marketplaces that aim to deter fraudulent sign-ups for coverage. Experts say the agency鈥檚 action indicates a problem exists.
Medicare officials tentatively plan to restrict the use of a controversial Alzheimer鈥檚 drug to only those patients participating in clinical trials, while the Department of Health and Human Services looks into lowering the monthly Medicare Part B premium. Meanwhile, covid confusion still reigns, as the Biden administration moves, belatedly, to make more masks and tests available. Joanne Kenen of Politico and the Johns Hopkins Bloomberg School of Public Health, Sarah Karlin-Smith of the Pink Sheet and Rachel Cohrs of Stat join KHN鈥檚 Julie Rovner to discuss these issues and more.
Despite state Republican leaders鈥 rigid opposition to expanding the health program designed for low-income residents, advocates successfully gathered enough signatures to get the measure on the fall ballot.
A new law makes California the first state to require that health insurance plans, including Medicaid, cover home STI tests. But some details still need to be worked out.
Legislative crackdowns on out-of-network bills haven鈥檛 kept specialists from hitting patients with unexpected charges running into thousands of dollars.
Nearly 14 million Americans have enrolled in Affordable Care Act marketplace health plans for next year 鈥 a record since the health law鈥檚 coverage expansion took effect in 2014. A boost in subsidies marketing and assistance in navigating the process increased the rolls of the insured.
Sen. Joe Manchin (D-W.Va.) dealt a blow to congressional efforts to pass President Joe Biden鈥檚 domestic agenda bill, forcing Democrats to regroup starting in 2022. Meanwhile, the omicron covid variant spreads rapidly in the U.S., threatening the stability of the nation鈥檚 health care system. Joanne Kenen of Politico and the Johns Hopkins School of Public Health, Rachel Cohrs of Stat and Sarah Karlin-Smith of the Pink Sheet join KHN鈥檚 Julie Rovner to discuss these issues and more, plus a look back at the year in health policy. Also this week, Rovner interviews Ceci Connolly, president and CEO of the Alliance of Community Health Plans.
Regular use of a more advanced screening method turns a low-cost procedure into a pricier one.
Many of the 14 million patients in Medi-Cal are in managed care health plans that outsource their care to subcontractors or sub-subcontractors. For patients with difficult health care needs, it can be hard to know where to turn.
The letters function as liens that 鈥減rotect鈥 spine surgery clinics while patients could be left with inflated medical bills and unexpected health risks.
Families of four with incomes of less than about $40,000 a year can pay no premiums and have low deductibles. For some others, health insurance in 2022 will cost more than in 2021 鈥 in some cases, significantly more.
After baby Dorian Bennett arrived two months early and spent more than 50 days in the neonatal ICU, his parents received a bill of more than $550,000 鈥 despite having insurance. The Florida hospital had a not-so-helpful suggestion: monthly payments of more than $45,000 for a year.
Law professor Jackie Fox looks at health insurance policies like any other contract, and she has spent 30 years making sound legal arguments to help patients get the care they need.
Medicare billing codes for audio-only follow-up check-ins lead to new reimbursement battles.
Voters in Missouri and Oklahoma approved Medicaid expansion to begin in 2021. But while Oklahoma has enrolled over 200,000 people so far, Missouri has enrolled fewer than 20,000. Why are two such similar states handling the public insurance rollout so differently?
Listen to a journalist's first-person horror story on shopping for health insurance 鈥 and learn how to avoid the pitfalls.
Health care 鈥 and how much it costs 鈥 is scary. But knowledge is power. Take a master class in winning insurance appeals. In the case of Matthew Lientz, taking on his insurance also meant going up against his employer.
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