Elisabeth Rosenthal

This State Isn’t Waiting for Biden To Negotiate Drug Prices

KFF Health News Original

As the federal government negotiates with drugmakers to lower the price of 10 expensive drugs for Medicare patients, impatient legislators in some states are trying to go even further. Leading the pack is Colorado, where a new Prescription Drug Affordability Review Board is set to recommend an “upper payment limit” for drugs it deems unaffordable. In late […]

How Your In-Network Health Coverage Can Vanish Before You Know It

KFF Health News Original

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 No Surprises Act Comes With Some Surprises

KFF Health News Original

The No Surprises Act, the landmark law intended to protect patients from surprise out-of-network medical bills, has come with, well, some surprises. A little more than two years after it took effect, there’s good and bad news about how it’s working. First, it’s important to note that the law has successfully protected millions of patients […]

The FTC Escalates Biden’s Fight Against Drug Prices

KFF Health News Original

It’s daggers out at the Federal Trade Commission in its fight against anticompetitive practices in health care. This past year, it has issued more stringent guidelines to block and discourage hospital mergers, and it investigated practices by middlemen in the drug supply chain. Now drug manufacturers themselves are in the agency’s crosshairs. In November, the FTC challenged the validity of more […]

Denials of Health Insurance Claims Are Rising — And Getting Weirder

KFF Health News Original

The Department of Health and Human Services is tasked with monitoring denials both by Obamacare health plans and those offered through employers and insurers. As insurers’ denials become more common, they sometimes defy not just medical standards of care but sheer logic. Why hasn’t the agency fulfilled its assignment?