The state wants to stop paying Kaiser Permanente for treating severely mentally ill Medi-Cal patients in Sacramento and Solano counties and force the counties to take on the task. The counties’ leaders say they can’t afford it.
Category: Insurance
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.
Why Does Insulin Cost So Much? Big Pharma Isn’t the Only Player Driving Prices
Big Pharma may be moving on from squeezing diabetes patients on insulin prices, but it’s the arbitrators that jack up prices for those who can least afford them.
Medicaid Health Plans Try to Protect Members — And Profits — During Unwinding
States are turning to the big health insurance companies to keep Medicaid enrollees insured once pandemic protections end in April. The insurers’ motive: profits.
March Medicaid Madness
With Medicare and Social Security apparently off the table for federal budget cuts, the focus has turned to Medicaid, the federal-state health program for those with low incomes. President Joe Biden has made it clear he wants to protect the program, along with the Affordable Care Act, but Republicans will likely propose cuts to both […]
California’s Massive Medicaid Program Works for Some, but Fails Many Others
Medi-Cal serves more than one-third of the state’s population — offering a dizzying range of care to a diverse population. In the new “Faces of Medi-Cal” series, California Healthline will assess the program’s strengths and weaknesses through the lives and experiences of its enrollees.
After People on Medicaid Die, Some States Aggressively Seek Repayment From Their Estates
States take drastically different approaches to recovering Medicaid money from deceased participants’ estates. Demands for repayment of Medicaid spending can drain the assets a person leaves behind, depending on where they lived.
Biden Promises to Fight GOP on ‘Gutting’ Medicaid. Budget Talks Seem Like Another Story.
As many lower-income Americans prepare to lose pandemic-era access to Medicaid, President Joe Biden vowed to stop Republicans from making deeper cuts to lower the national debt. Other changes may still be up for discussion.
Idaho Dropped Thousands From Medicaid in the Pandemic’s First Years
The removals, detailed in emails between state and federal health officials, hinged on disagreements over how states could disenroll people during the public health emergency. Consumer advocates fear the alleged violation signals the mess to come on April 1, when the pandemic-era Medicaid coverage mandate ends.
Surprise-Billing Law Loophole: When ‘Out of Network’ Doesn’t Quite Mean Out of Network
Billing experts and lawmakers are playing catch-up as providers find ways to get around new surprise-billing laws, leaving patients like Danielle Laskey of Washington state with big bills for emergency care.
