Latest California Healthline Stories
5 Takeaways From Health Insurers’ New Pledge To Improve Prior Authorization
Dozens of health insurance companies pledged on Monday to improve prior authorization, a process often used to deny care. The announcement comes months after the killing of UnitedHealthcare executive Brian Thompson, whose death in December sparked widespread criticism about insurance denials.
Their Physical Therapy Coverage Ran Out Before They Could Walk Again
Health plans limit physical or occupational therapy sessions to as few as 20 a year, no matter the patient’s infirmities. The limits persist despite federal rules banning insurers from setting annual dollar limits on the care they will provide.
The Medicare Advantage Influence Machine
New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges.
How Your In-Network Health Coverage Can Vanish Before You Know It
One of the most unfair aspects of medical insurance is this: Patients can change insurance only during end-of-year enrollment periods or at the time of “qualifying life events.” But insurers’ contracts with doctors, hospitals, and pharmaceutical companies can change abruptly at any time.
The Colonoscopies Were Free. But the ‘Surgical Trays’ Came With $600 Price Tags.
Health providers may bill however they choose — including in ways that could leave patients with unexpected bills for “free” care. Routine preventive care saddled an Illinois couple with his-and-her bills for “surgical trays.”
When a Quick Telehealth Visit Yields Multiple Surprises Beyond a Big Bill
For the patient, it was a quick and inexpensive virtual appointment. Why it cost 10 times what she expected became a mystery.
Out for Blood: For Routine Lab Work, the Hospital Billed Her $2,400
Convenient as it may be, beware of getting your blood drawn at a hospital. The cost could be much higher than at an independent lab, and your insurance might not cover it all.
Quick Genetic Test Offers Hope for Sick, Undiagnosed Kids. But Few Insurers Offer to Pay.
A new, rapid genetic test shows promise in increasing diagnoses and improving treatment for some children with rare genetic conditions. Many insurers won’t cover it, but Florida’s Medicaid program is among those that see benefits — and, potentially, savings.
Pruebas genéticas rápidas a bebés pueden salvar vidas, pero muchas aseguradoras no las cubren
Que Medicaid cubra la prueba puede expandir significativamente el acceso para los bebés; el programa de salud federal gerenciado por los estados que asegura a las familias de bajos ingresos y que cubre a más del 40% de los niños en su primer año de vida.
Patients Squeezed in Fight Over Who Gets to Bill for Pricey Infusion Drugs
To drive down costs, insurers are bypassing hospital system pharmacies and delivering high-priced infusion drugs, including some used in chemotherapy, via third-party pharmacies. Smarting from losing out on billing for those drugs, hospitals and clinics are trying to convince states to limit this practice, known as “white bagging.”