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Lawmakers across the country and federally have been trying to figure out the best way to address surprise medical bills. But one of the main causes of the problem –ambulance rides — isn’t in any of the proposed legislation. “If you call 911 for an ambulance, it’s basically a coin flip whether or not that ambulance will be in or out of network,” said Christopher Garmon, a health economist at the University of Missouri-Kansas City. Meanwhile, legislation in the House over the bills is unlikely to be addressed until after August recess.
The Trump administration issued a regulation last year allowing short-term health care plans to last up to 12 months instead of three. The plans don’t have to adhere to the health law’s strict regulations, so critics blast them as being “junk insurance.” U.S. District Judge Richard Leon, however, ruled that the plans aims to “minimize the harm and expense” for individuals who might otherwise decide not to purchase insurance because of high premiums.
Health care is one of the dividing issues for the crowded 2020 Democratic field, but the candidates’ stances on the issue underscore how different their philosophies can be. Meanwhile, those candidates who support “Medicare for All” are still grappling with the issue of how to pay for it. And The New York Times fact checks President Donald Trump’s rhetoric on the Democrats’ plans.
The case centers on 80,000 events Novartis held between 2002 and 2011 that federal prosecutors allege amounted to kickbacks masquerading as educational meetings.
Lauren Sullivan had been trying to appeal UnitedHealth’s initial refusal of the drug for her 21-month-old daughter, Daryn. The girl was running out of time to receive the treatment before her second birthday in October, when the drug has to be administered. The company also approved claims for three other patients. In other news, UnitedHealth beats expectations for the quarter, prompting company to boost earnings guidance.
Sens. Mike Lee (R-Utah) and Sen. Rand Paul (R-Ky.) raised concerns about the cost of the fund, which has been thrust into the national spotlight after comedian Jon Stewart lambasted House lawmakers for the delays in shoring up the payments.
Presidential hopefuls Sen. Bernie Sanders (I-Vt.) and former Vice President Joe Biden would take separate paths on how to address health care, with Sanders going for an overhaul approach and Biden favoring building on what exists. The two philosophies have come to divide a crowded pack of Democrats as the election season starts kicking into gear, and in the past few days Sanders and Biden have been publicly swiping at each other over the issue. Meanwhile, governors are particularly worried about candidates’ rhetoric about getting rid of private insurers.
Prosecutors say Joseph Prince, a former Veterans Affairs employee, exploited his position of trust to steer patients to seven different home health agencies that subsequently kicked back money to Prince and his family.
Media outlets report on news from California, District of Columbia, Puerto Rico, Illinois, Virginia, Florida, Minnesota, Massachusetts, North Carolina, Ohio, Arizona, Wisconsin and New Hampshire.
Although the guidance shifts costs to insurers, the companies have actually been pushing for the flexibility to begin providing coverage for those treatments, such as glucose or blood-pressure monitors, because people who don’t get ongoing treatment for a disease can have their condition worsen, leaving insurers paying even more for their care.
2020 hopeful Sen. Bernie Sanders speech at George Washington University came amid a public battle between him and rival candidate Vice President Joe Biden, who wants to take more incremental steps on health care. But many of the claims he made about what the plan would save were dubious, an Associated Press fact check found.
Lawmakers are gung-ho about addressing the issue of surprise medical bills, but the central question of who covers the costs instead remains. The debate is drawing out major health care players to push for the best outcome in the fight. On Wednesday, the House Energy and Commerce Committee approved its version of the legislation.
Sen. Bernie Sanders (I-Vt.) invited his fellow presidential candidates to join him in refusing to accept contributions over $200 from political action committees, lobbyists and executives of health insurance and drug companies. But an ABC News review of FEC records identified at least three contributions of more than $200 from two individual donors who could be considered executives at companies in those fields.
The “Cadillac tax,” which never went into effect, was intended to help control costs by putting a brake on the value of health insurance plans and avoid having insurers and employers shifting more costs to policyholders. Its implementation has been delayed for years, and House Democrats voted to repeal it once and for all. It still needs to go to the Senate, but in all likelihood the upper chamber will eagerly follow suit, as Republicans didn’t like the provision.
But the company’s legal challenges loom like a dark cloud over the good news. Other news from the health industry focuses on telemedicine, value-based care and glucose monitors.
The tax, which has been repeatedly delayed, would have been on the most generous and expensive employer health-insurance plans. But lawmakers are under pressure from labor unions to kill it.
The vote on the amendment, confirmed to Modern Healthcare by three sources close to discussions, will take place Wednesday along with a swath of health care measures including a two-year delay to the disproportionate share hospital cuts. Meanwhile, the CBO projected on Tuesday that the Senate’s surprise medical bill legislation would save $7.6 billion over a decade.
Media outlets report on news from Rhode Island, Colorado, Minnesota, Missouri, Georgia, Connecticut, Nevada, Massachusetts, New Jersey, New York, Oklahoma, Oregon, Pennsylvania and California.
There are concerns from experts who say patients may not fully understand the privacy implications of new records apps and end up signing a lot of their information away without realizing it. Other news at the intersection of technology and health care: artificial intelligence and dental bills, telemedicine in rural areas, wireless health hazards and more.