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Biden Cracks Down on Prior Authorization — But There Are Limits

KFF Health News Original

More than a year after it was initially proposed, the Biden administration announced a final rule yesterday that will change how insurers in federal programs such as Medicare Advantage use prior authorization — a long-standing system that prevents many patients from accessing doctor-recommended care. “When a doctor says a patient needs a procedure, it is […]

Will CMS Crack Down on Prior Authorization?

KFF Health News Original

There’s the Idaho doctor whose infant daughter developed a brain tumor. A woman in Southern California who waited months for an MRI before dying in the hospital. And a North Carolina patient who has trigeminal neuralgia — a condition so painful it’s commonly called the “suicide disease.” They all have something in common, aside from […]

Medicaid’s ‘Unwinding’ Can Be Especially Perilous for Disabled People

KFF Health News Original

Earlier this year, Beverly Likens thought she’d done everything she needed to do to keep her Medicaid. Then came an unwelcome surprise: Ahead of surgery to treat chronic bleeding, the hospital said her insurance was inactive, jeopardizing her procedure. Likens had just been diagnosed with severe anemia and given a blood transfusion at the emergency room. “I […]

KFF Health News' 'What the Health?': Let’s Talk About the Weather

Podcast

It’s been the summer of broken weather records around the world — for heat, rain, and wildfire smoke — advertising the risks of climate change in a big way. But, apparently, it’s not enough to break the logjam in Washington over how to address the growing climate crisis. Meanwhile, in Texas, women who were unable to get care for pregnancy complications took their stories to court, and Congress gears up to — maybe — do something about prescription drug prices. Alice Miranda Ollstein of Politico, Shefali Luthra of The 19th, and Rachel Cohrs of Stat join Julie Rovner, KFF Health News’ chief Washington correspondent, to discuss these issues and more. Also this week, Rovner interviews Meena Seshamani, the top administrator for the federal Medicare program.