Category: Insurance

In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M

A whistleblower suit alleged a health insurer bilked Medicare by exaggerating how sick patients were.

Employers Press Congress To Cement Health Price Transparency Before Trump’s Return

Donald Trump’s first administration advanced rules forcing hospitals and insurers to reveal prices for medical services. Employers don’t want to risk backtracking during Trump’s second administration.

Obamacare Sign-Ups Lag After Trump Election, Legal Challenges

The number of new and returning enrollees using healthcare.gov — the federal marketplace that serves 31 states — is well below last year’s as of early December. Also, a Biden administration push to give “Dreamers” access to Obamacare coverage and subsidies is facing court challenges.

He Went in for a Colonoscopy. The Hospital Charged $19,000 for Two.

A man in Chicago with a troubling symptom underwent a common procedure. Then he wanted to know why the hospital charged nearly three times its own cost estimate.

Democratic Senators Ask Watchdog Agency To Investigate Georgia’s Medicaid Work Rule

A group of Democratic senators asked the Government Accountability Office to examine a Georgia program that requires some Medicaid enrollees to work, study, or volunteer 80 hours a month for coverage. They cited KFF Health News’ reporting, which has documented the program’s high costs and low enrollment.

Rage Has Long Shadowed American Health Care. It’s Rarely Produced Big Change.

The outpouring of anger at health insurers following the killing of UnitedHealthcare CEO Brian Thompson continues a cycle of rage that dates back decades.

Trump Threat to Immigrant Health Care Tempered by Economic Hopes

Donald Trump’s second term is reigniting mistrust in health services among California immigrants, making it harder for community health workers to get people enrolled in Medi-Cal. Yet the president-elect is also seen as someone who could improve their lives with a better economy, even if that means forgoing health care.

Removing a Splinter? Treating a Wart? If a Doctor Does It, It Can Be Billed as Surgery

Minor interventions are increasingly being rebranded and billed as surgery, for profit. This means a neurologist spending 40 minutes with a patient to tease out a diagnosis can be paid less for that time than a dermatologist spending a few seconds squirting a dollop of liquid nitrogen onto the skin.

KFF Health News’ ‘What the Health?’: A Killing Touches Off Backlash Against Health Insurers

The shocking shooting death of UnitedHealthcare’s chief executive in Midtown Manhattan prompted a public outcry about the problems with the nation’s health care system, as stories of delayed and denied care filled social media. Meanwhile, President-elect Donald Trump continues to avoid providing specifics about his plans for the Affordable Care Act and other health issues. Alice Miranda Ollstein of Politico, Sandhya Raman of CQ Roll Call, and Rachel Cohrs Zhang of Stat join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews Francis Collins, who was the director of the National Institutes of Health and a science adviser to President Joe Biden.

Federal Judge Halts Dreamers’ Brand-New Access to ACA Enrollment in 19 States

A federal judge sided with 19 states seeking an injunction against a Biden administration rule allowing recipients of Deferred Action for Childhood Arrivals to enroll in Affordable Care Act coverage and qualify for subsidies amid the annual open enrollment period.