The Centers for Medicare & Medicaid Services backed off from a plan that could have curtailed access to a type of reconstructive surgery known as DIEP flap. Breast cancer patient advocates are relieved.
Category: CMS
The Real Costs of the New Alzheimer’s Drug, Most of Which Will Fall to Taxpayers
The annual cost of lecanemab treatment quadruples if the expense of brain scans to monitor for bleeds and other associated care is factored in. The full financial toll likely puts it beyond reach for low-income seniors at risk of Alzheimer’s, experts say.
KFF Health News’ ‘What the Health?’: Let’s Talk About the Weather
2023 will likely be remembered as the summer Arizona sizzled, Vermont got swamped, and nearly the entire Eastern Seaboard, along with huge swaths of the Midwest, choked on wildfire smoke from Canada. Still, none of that has been enough to prompt policymakers in Washington to act on climate issues. Meanwhile, at a public court hearing, […]
How a Medical Recoding May Limit Cancer Patients’ Options for Breast Reconstruction
The federal government’s arcane process for medical coding is influencing which reconstructive surgery options are available, creating anxiety for breast cancer patients.
Doctor Shortages Distress Rural America, Where Few Residency Programs Exist
Patients in rural northeastern Nevada soon will have fewer providers and resources, after a local hospital decided to close its medical residency program. Nationally, the number of rural residency slots has grown during the past few years but still makes up just 2% of programs and residents nationwide.
The Big Squeeze: More Enrollees and Smaller Networks Plague Some ACA Plans
Despite record enrollment in health insurance plans under the Affordable Care Act, some consumers who bought coverage and agents who helped them do so have had a tough start to the new year: Many say it’s hard to find an in-network doctor or hospital.
A Progress Check on Hospital Price Transparency
Hospitals are facing mixed reviews regarding their efforts to comply with a federal requirement that they post information about prices related to nearly every health care service they provide.
Congressman Seeks to Plug ‘Shocking Loophole’ Exposed by KHN Investigation
A federal lawmaker has introduced a House bill that would close one of a laundry list of oversight gaps revealed in a recent KHN investigation of the system regulators use to ban fraudsters from billing government health programs, including Medicare and Medicaid.
Feds Move to Rein In Prior Authorization, a System That Harms and Frustrates Patients
The federal government wants to change the way health insurers use prior authorization — the requirement that patients get permission before undergoing treatment. Designed to prevent doctors from deploying expensive, ineffectual procedures, prior authorization has morphed into an unwieldy monster that denies or delays care, burdens physicians with paperwork, and perpetuates racial disparities. New federal rules may not be enough to tame it.
Struggling to Survive, the First Rural Hospitals Line Up for New Federal Lifeline
Hospitals in New Mexico, Texas, and Oklahoma are among the first to apply for a new rural hospital payment model that shifts the focus of services away from overnight stays to outpatient and emergency care. Still, experts say the law needs to be amended to provide the right mix of care for rural communities.
