The Biden administration is weighing how to treat urgent care clinics as part of broad regulations banning surprise, out-of-network medical bills. At the heart of the matter: What counts as an emergency?
Category: Cost and Quality
Diabetes Drug’s New Weight Loss Formula Fuels Cost-Benefit Debate
Health plans’ coverage of the medication, branded as Wegovy — which has a $1,300-a-month price tag — is not a sure thing.
Pfizer Court Fight Could Legalize Medicare Copays and Unleash ‘Gold Rush’ in Sales
Pharmaceutical companies routinely cover the cost of patient copays for expensive drugs under private insurance. A federal judge could make the practice legal for millions on Medicare as well.
Olympic Dream Dashed After Bike Crash and Nightmare Medical Bill Over $200K
A bicyclist from California competed in a Pennsylvania race that could have landed him in this month’s Tokyo Olympics. Instead, a crash on the velodrome track landed him in two hospitals where his out-of-state, out-of-network surgeries garnered huge bills.
Bye-Bye to Health Insurance ‘Birthday Rule’? Kansas Lawmaker Floats Fix
U.S. Rep. Sharice Davids (D-Kansas) introduced a bill to do away with a health insurance rule that dictates which parent’s plan becomes a new baby’s primary insurer. This could save some parents from unexpected, sometimes massive medical bills. Davids took up the issue after a KHN/NPR Bill of the Month story on one family’s unexpected $207,455 NICU bill.
Facing Headwinds on New Alzheimer’s Drug, Biogen Launches Controversial Campaign
The makers of Aduhelm, a drug approved last month despite concerns raised by experts about its effectiveness, have launched a website and ads designed to urge people who are worried about their memory to ask doctors about testing. But some health advocates say it is misleading because some memory loss with aging is normal.
KHN’s ‘What the Health?’: Delta Changes the Covid Conversation
With covid cases on the upswing again around the country, partisan division remains over how to address the pandemic. Meanwhile, the Biden administration proposes bigger penalties for hospitals that fail to make their prices public as required. Stephanie Armour of The Wall Street Journal, Alice Miranda Ollstein of Politico and Tami Luhby of CNN join KHN’s Julie Rovner to discuss these issues and more. Also, for “extra credit,” the panelists suggest their favorite stories of the week they think you should read, too.
Sen. Wyden: $3.5T Budget May Have to Trim but It Can Set a Path to ‘Ambitious Goals’
Sen. Ron Wyden (D-Ore.), who is helping to negotiate the health care spending framework for the Democrats’ budget plan, said lawmakers may have to settle for very basic versions of programs deployed in the package. But the key, he added, is to get the “architecture of these changes, bold changes,” started and show people what is possible.
California Makes It Easier for Low-Income Residents to Get and Keep Free Health Coverage
State lawmakers aim to expand Medicaid enrollment by dedicating billions of dollars in coming years to simplifying paperwork, extending pregnancy coverage and opening the program to thousands of new enrollees, including older unauthorized immigrants and people who need nursing home care.
Hospital ‘Trauma Centers’ Charge Enormous Fees to Treat Minor Injuries and Send People Home
Only severely injured patients are supposed to be billed for “trauma team alert” fees that can exceed $50,000.
