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Beneficiaries seeking to continue a prescription medication that has been removed from the plan’s list of approved drugs needs to get a doctor to make the case to the insurer.
The Trump administration rolled out a list of actions to attack drug prices, but most dance around the edges.
Kaiser Health News Editor-in-Chief Elisabeth Rosenthal discussed drug costs with Scott Simon, the host of NPR’s Weekend Edition on Saturday, Feb. 10. This is a transcript of that conversation.
The agreement would add $2 billion to the National Institutes of Health and fund community health centers around the country. But it does not include provisions to help stabilize the federal health law’s marketplaces.
With another piece of must-pass legislation set to move through Congress, there’s a push to attach provisions to keep afloat a number of health-related programs for which funding or specific federal direction has expired.
While the federal health law made insurers cover the full cost of screening colonoscopies, consumers with a history of polyps who need more frequent tests may have to pick up some costs.
For some federal health programs, a shuttered government means business as usual. But the congressional impasse over funding will hit others hard.
Agencies sometimes turn away Medicare beneficiaries with chronic health problems by incorrectly claiming Medicare won’t pay their services, say patient advocates.
In California, Medicare penalized 30 percent of the hospitals it assessed. Seven states saw a third or more of their hospitals punished under the federal heath law’s campaign against hospital-acquired conditions.
Medicare is discouraging regional offices from levying fines for “one-time mistakes” or from using daily fines that seek to put pressure on nursing homes to make changes.