Latest California Healthline Stories
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 become a confusing maze that denies or delays care, burdens physicians with paperwork, and perpetuates racial disparities. New rules may not be enough to solve the problems.
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.
Hospitales rurales aplican a nuevo programa federal para intentar sobrevivir
Más de 140 hospitales rurales han cerrado en todo el país desde 2010, y observadores de políticas de salud no están seguros de cuántas de las más de 1,700 instalaciones rurales elegibles para la nueva designación aplicarán a un nuevo programa.
Proposed Medicare Advantage Changes Cannot Accurately Be Called ‘Cuts,’ Experts Say
CMS advanced two proposed changes that could affect Medicare Advantage plans. One would allow the government to recover past overpayments. As a result, it could reduce those insurers’ profits, leading them to increase enrollees’ out-of-pocket costs or reduce benefits. But it’s inaccurate to characterize the changes as “cuts.”
Millions of Californians Are at Risk of Losing Medi-Cal Coverage
As the nation’s massive Medicaid unwinding begins, California is using government databases, billboards, and navigators to help people who get dropped from Medi-Cal reenroll or find other coverage.
Millones en riesgo de perder Medicaid, mientras terminan protecciones por la pandemia
Los estados se están preparando para remover a millones de personas de Medicaid, a medida que expiran las protecciones que se implementaron al comienzo de la pandemia de covid-19.
Nursing Home Owners Drained Cash During Pandemic While Residents Deteriorated
As the federal government debates whether to require higher staffing levels at nursing homes, financial records show owners routinely push profits to sister companies while residents are neglected. “A dog would get better care than he did,” one resident’s wife said.
Government Lets Health Plans That Ripped Off Medicare Keep the Money
In a surprise decision, U.S. officials yield to insurance industry demands — at least for now.
Did Your Health Plan Rip Off Medicare?
KHN has released never-before-seen details of federal audits as the government weighs action against dozens of Medicare Advantage plans.