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Pharmacy benefit managers have curtailed in-person audits of pharmacy claims during the pandemic, switching to virtual audits done by computer. That has markedly increased the number of claims they can review — and the chances for payment denials — squeezing pharmacies and bringing in more cash for the benefit companies.
U.S. Rep. Sharice Davids (D-Kansas) introduced a bill to do away with a health insurance rule that dictates which parent’s plan becomes a new baby’s primary insurer. This could save some parents from unexpected, sometimes massive medical bills. Davids took up the issue after a KHN/NPR Bill of the Month story on one family’s unexpected $207,455 NICU bill.
Missouri is the last state to create a monitoring program to help spot the misuse of prescription drugs. But some public health experts warn that the nation’s programs are forcing people addicted to opioids to seek deadlier street options.
At the center of the nation’s delta variant outbreak, public health efforts are mired in a political turf war.
Black women and girls with attention deficit hyperactivity disorder often remain undiagnosed because their symptoms are mischaracterized by the blinders of sexism and racism. Getting treatment and finding the right medication can be even more difficult because they aren’t taken seriously or, worse, they’re racially profiled while getting their medicines.
In an ongoing effort to control prescription drug costs, states are targeting the companies that mediate deals among drug manufacturers, health insurers and pharmacies. The pharmacy benefit managers say they negotiate lower prices for patients, yet the nitty-gritty occurs largely behind a curtain that lawmakers are trying to pull back.
St. Louis Blues leading scorer David Perron took 10 days to explain he had indeed been vaccinated before he caught covid-19, which knocked him from playing in the NHL playoffs against the Colorado Avalanche. His case and those of other public figures raise questions about the role of celebrity in enticing people to get covid vaccinations.
Across Missouri, more than 100 schools have spent over $3.5 million — often at the taxpayers’ expense — snapping up ionization and other air-purifying devices in an attempt to keep kids safe from covid-19. But experts warn the largely unregulated technology hasn’t been thoroughly tested in classroom settings and is “often unproven.â€
The pandemic created disruption and family stress that may have lasting effects on young children’s social and emotional development.
When estimating how well a patient’s kidneys are working, doctors frequently turn to an equation that depends on a question: Is the patient Black? Kidney experts are now debating how to remove the race adjustment and whether the question is a function of sound science. It’s considered just the first step in dismantling institutional racism in kidney care.
Racial and ethnic categories for vaccination data vary widely from one state to another, complicating efforts to distribute shots where they are needed most. In Missouri, some red flags in the data surfaced, making health officials question its usefulness.
Each year, hundreds of thousands of new mothers lose Medicaid coverage after 60 days when their income exceeds limits. But deadly childbirth complications persist months longer.
A significant number of post-covid patients suffer from syndromes that few doctors understand.
No-shows for behavioral health appointments have been a long-standing problem, with up to 60% skipped. Now telehealth, fueled by the pandemic, makes it easier for people dealing with depression and other mental health issues to make it to their appointments at a time when such care is in high demand. But teletherapy creates other challenges.
Black Americans’ vaccination rates still trail all other groups, while Hispanics show improvement. Native Americans show the strongest rates nationally.
Struggling to keep up with a covid-19 surge in Michigan, overwhelmed health departments relied on an unlikely new crew of contact tracers: school principals.
Camp Ho Mita Koda, an Ohio camp for children with diabetes, plans to host in-person camp this year despite the pandemic. It’s unusual, especially given that children under 12 likely won't be able to get covid vaccines for months and many who attend medically focused camps could be especially vulnerable to serious covid complications. But these camps are important not just for the kids, but also for parents.
The pandemic has been stressful for millions of children. Schools are trying to meet children's emotional needs in big and small ways as in-person classes resume.
Pandemic lockdowns exacerbated long-standing economic pressures on pharmacies — and forced many owner-operated shops to evolve or risk closing their doors.
Across Appalachia and the Mississippi Delta, where death rates from stroke are above the national average, routing patients from rural areas to the right level of care can be an intricate jigsaw puzzle. The closest hospital might not offer the full scope of stroke treatments, but hospitals with more advanced care could be hours away.
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