News

A three-judge federal appeals court panel in Connecticut has likely ended an 11-year fight against a frustrating and confusing rule that left hundreds of thousands of Medicare beneficiaries without coverage for nursing home care, and no way to challenge a denial. The Jan. 25 ruling, which came in response to a 2011 class-action lawsuit eventually joined by 14 beneficiaries against the Department of Health and Human Services, will guarantee patients the right to appeal to Medicare for nursing home coverage if they were admitted to a hospital as an inpatient but were switched to observation...
Even Eden, a snow-covered paradise in northern Vermont, is poisoned by omicron. The nearly vertical ascent of new coronavirus cases in recent weeks, before peaking in mid-January, affected nearly every mountain hamlet, every shuttered factory town, every frozen bucolic college campus in this state despite its near-perfect vaccination record. Of all the states, Vermont appeared best prepared for the omicron battle: It is the nation’s most vaccinated state against covid, with nearly 80% of residents fully vaccinated — and 95% of residents age 65 and up, the age group considered most vulnerable...
Can’t see the audio player? Click here to listen. KHN Southern California correspondent Bernard J. Wolfson was on “Línea Abierta,” a Radio Bilingüe weekday news program, answering questions for a Spanish-speaking audience about his recent column on health plan enrollment through California’s Affordable Care Act marketplace, Covered California.
Can’t see the audio player? Click here to listen on Acast. You can also listen on Spotify, Apple Podcasts, Stitcher, Pocket Casts or wherever you listen to podcasts.
ATLANTA — Georgia lawmakers will consider a bill that could force the state’s Medicaid managed-care insurers to repay millions of dollars if their spending on medical care doesn’t reach a certain threshold. The bipartisan bill, introduced Jan. 26 by the powerful Georgia House Speaker David Ralston, a Republican, is focused on improving the state’s mental health care system. Tucked inside the legislation is a provision that would require the Medicaid managed-care companies to refund payments to the state if they don’t spend enough on medical care and quality improvements for patients.
“CBS Mornings” host Tony Dokoupil interviewed KHN Editor-in-Chief Elisabeth Rosenthal about January’s Bill of the Month installment, a collaboration with NPR. The Bhatt family of St. Peters, Missouri, was charged $1,012 for an emergency room visit for son Martand. The toddler had burned his hand on a stove days before, and, after it started blistering, his pediatrician recommended a trip to the emergency room at the nearest children’s hospital. A nurse practitioner examined the child and recommended a surgeon also see the wound. But the surgeon didn’t show after more than an hour, and the...
A boisterous political battle over a proposed expansion by the largest and most expensive hospital system in Massachusetts is spotlighting questions about whether similar expansions by big health systems around the country drive up health care costs. Mass General Brigham, which owns 11 hospitals in the state, has proposed a $2.3 billion expansion including a new 482-bed tower at its flagship Massachusetts General Hospital in Boston and a 78-bed addition to Brigham and Women’s Faulkner Hospital. The most controversial element, however, is a plan to build three comprehensive ambulatory care...
The Centers for Disease Control and Prevention reached out to pharmacists Wednesday to reinforce the message that people with moderate to severe immune suppression are eligible for fourth covid shots. The conference call came a day after KHN reported that immunocompromised people were being turned away by pharmacy employees unfamiliar with the latest CDC guidelines.
Durante tres años, Rachel Makkar dijo que prosperó en su trabajo como agente de bolsa y gestora de activos en J&B Building Company, en Colorado. Su desempeño laboral era sobresaliente y aseguró que así lo reflejaban sus evaluaciones. Pensaba que era “el mejor lugar en el que había trabajado”. Pero todo cambió en agosto. Tras intentar concebir un segundo hijo durante “mucho tiempo”, un fin de semana sufrió en casa un aborto espontáneo temprano. Ese lunes no pudo ir a trabajar. “Estaba muy traumatizada”, contó. “Toda esa primera semana fue emocionalmente muy dura para mí”. Además, tenía una...
Betty Chow, a Los Angeles resident, had a cervical disc replaced in August 2020 at a surgery center that was part of her Anthem Blue Cross PPO network. Thirteen months later, she was blindsided by a bill for nearly $2,000 from the anesthesiologist who was on her surgical team but was not contracted with her PPO, or preferred provider organization. Chow, a 35-year-old veterinarian, says she discussed the bill with her boyfriend, a registered nurse. He told her about a California law that took effect in 2017 and prohibits such “surprise bills” from out-of-network medical providers who work at...
For three years, Rachel Makkar said, she thrived in her job as a broker and asset manager at J&B Building Co. in Colorado. She excelled at her work — she said her performance reviews noted that — and she thought it was “the best place I’ve ever worked.” That changed in August. After trying for “a really long time” to conceive a second child, she suffered an early miscarriage at home one weekend. She couldn’t go to work that Monday. “I was really traumatized,” she said. “That entire first week was like a heightened level of emotion that I hadn’t really been through before.” She also had a...
Los pacientes con sistemas inmunes debilitados, que tienen un riesgo mayor de covid-19 y sus complicaciones, dicen que las farmacias los rechazan cuando buscan dosis adicionales de las vacunas recomendadas por los funcionarios federales de salud. Alyson Smith se convirtió en elegible en enero para una cuarta dosis de la vacuna contra covid porque sus medicamentos afectan su sistema inmune.
Patients with weakened immune systems — who are at high risk from covid-19 — say pharmacies are turning them away when they seek additional vaccine doses recommended by federal health officials. Alyson Smith became eligible this month for a fourth vaccine dose because her medications leave her immunocompromised. Although the Centers for Disease Control and Prevention encourages most adults to receive a total of three mRNA vaccines — two “primary” vaccinations and a booster — the agency now advises people with weak immune systems to receive three primary shots plus a booster, for a total of...
ST. CHARLES, Mo. — Jamie Smith, a staffing agency nurse who loves end-of-life care, said she has been warmly welcomed by staffers and residents at Frontier Health & Rehabilitation in this conservative St. Louis suburb. That’s even though she has not been vaccinated against covid-19.
I got a hurried voicemail from my pharmacist in Wisconsin the day before Thanksgiving letting me know my insurance was refusing to cover my insulin. I had enough of the hormone that keeps me alive to last 17 days. In my 10 years living with Type 1 diabetes, I’ve never really struggled to access insulin. But in my job reporting on the people left behind by our country’s absurdly complex health care system, I’ve written about how insulin’s steep cost leads to deadly rationing and about patients protesting to bring those prices down.
¿Qué grupo es especialmente vulnerable a los estragos de covid, incluso si está vacunado por completo y con sus refuerzos? Los adultos mayores. Sin embargo, ¿quién tendrá más dificultades para obtener pruebas caseras gratuitas para covid según el plan de la administración Biden? Sí, los adultos mayores. Desde el 15 de enero, las personas con seguro privado pueden comprar hasta ocho pruebas caseras rápidas de covid al mes, y sus planes de salud deben pagarlas, mientras dure la emergencia de salud pública.
Dhaval Bhatt had been warned about hospital emergency rooms. “People always told me to avoid the ER in America unless you are really dying,” said Bhatt, an immigrant from India who got a Ph.D. in pharmacology in the U.S. and is now a research scientist at Washington University in St. Louis. But when Bhatt’s 2-year-old son burned his hand on the kitchen stove on a Wednesday morning in April, the family’s pediatrician directed them the next day to the local children’s hospital. Bhatt was traveling. So, his wife, Mansi Bhatt, took their son to the hospital and was sent to the emergency room. A...
[UPDATED at 4 p.m. ET] What group is especially vulnerable to the ravages of covid-19 even if fully vaccinated and boosted? Seniors. And who will have an especially tough time getting free at-home covid tests under the Biden administration’s plan? Yes, seniors. As of Jan. 15, private insurers will cover the cost of eight at-home rapid covid tests each month for their members — for as long as the public health emergency lasts.
SACRAMENTO — California is poised to become the front line of America’s vaccination wars. State lawmakers are drafting the toughest covid-19 vaccine legislation in the country, backed by a new pro-vaccine lobbying force promising to counter anti-vaccine activists who have threatened government officials and shut down public meetings across the state. Legislators want to require most Californians to get the shots — not just schoolchildren and health care workers — and eliminate the exemptions that would allow many people to get out of them. But vaccine opponents say Democratic-led efforts to...
As the omicron variant completes its sweep across the U.S., states with scarce supplies of monoclonal antibody therapies continue to use two treatments that federal health officials warn no longer work against the highly contagious version of the virus that causes covid-19. The antibody treatment now most recommended is sotrovimab from GlaxoSmithKline and Vir Biotechnology, and it’s in short supply.

 

DISCLAIMER: The information found on this Web Site is dynamic and subject to change. Please use the "CONTACT US" section of the Web Site to submit any questions or comments.