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Diagnosed with aggressive leukemia on a Western trip, a young man thought his insurance would cover an air ambulance ride home to North Carolina. Instead, questions about medical necessity left him with an astronomical bill.
The No Surprises Act offers protection from many surprise medical bills — but that protection may be only as good as a patient’s knowledge of the law and ability to make sure it’s enforced. Here’s what you need to know.
The Biden administration’s request for billions more in funding to fight covid-19 hit a snag on Capitol Hill this week, as Democrats objected to Republican demands that money allocated to states but not yet spent be reclaimed. Meanwhile, the big annual spending bill about to cross the finish line addresses other health policy changes, such as giving the FDA authority to regulate “synthetic” nicotine. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Rachel Cohrs of Stat, and Jessie Hellmann of Modern Healthcare join KHN’s Julie Rovner to discuss these issues and more. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too.
The president used broad language to say that Americans no longer needed to worry about surprise bills, but there are exceptions to the new law that could cost unsuspecting consumers.
The insurance company said that the birth of the Bull family’s twins was not an emergency and that NICU care was “not medically necessary.” The family’s experience with a huge bill sent to collections happened in 2020, but it exposes a hole in the new No Surprises law that took effect Jan. 1.
Some practitioners object to the way upfront cost estimates are designed, saying they could affect access to care and are burdensome. Other experts disagree.
The No Surprises Act protects patients from surprise out-of-network bills. But there are caveats. For instance, these protections apply only to care in a hospital. This episode breaks it all down.
The new federal law will provide protection against surprise medical bills for between 6 million and 7 million Californians who are not covered under state law.
Jan. 22 marks the 49th — and very likely last — anniversary of the Supreme Court’s landmark abortion decision, Roe v. Wade. The court’s conservative supermajority seems poised to overturn later this year the ruling that legalized abortion nationwide. Also this week, the Biden administration turns 1, with much of its domestic and health agenda yet unrealized. Alice Miranda Ollstein of Politico, Shefali Luthra of the 19th, and Kimberly Leonard of Insider join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Marjorie Dannenfelser, president of the Susan B. Anthony List, about what a post-Roe world might look like.
It’s 2022 and the covid-19 pandemic is still with us, as are congressional efforts to pass President Joe Biden’s big health and social spending bill. But other issues seem certain to take center stage on this year’s health agenda, including abortion, the state of the health care workforce, and prescription drug prices. Tami Luhby of CNN, Alice Miranda Ollstein of Politico and Mary Ellen McIntire of CQ Roll Call join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KHN’s Victoria Knight, who reported the latest KHN-NPR “Bill of the Month” episode.
Years in the making, a new federal law against surprise medical bills took effect Jan. 1.
Our crowdsourced investigation of the high, confusing and arbitrary medical bills generated by our health system is set to begin its fifth year in 2022.
Legislative crackdowns on out-of-network bills haven’t kept specialists from hitting patients with unexpected charges running into thousands of dollars.
Regular use of a more advanced screening method turns a low-cost procedure into a pricier one.
Even before the omicron variant of covid starts to spread widely in the U.S., hospitals are filling up with post-holiday delta cases. Meanwhile, the Supreme Court signals — loudly — that 2022 will be the year it rolls back abortion rights in a big way. Margot Sanger-Katz of The New York Times, Alice Miranda Ollstein of Politico and Mary Ellen McIntire of CQ Roll Call join KHN’s Julie Rovner to discuss these issues and more.
The American Medical Association and American Hospital Association are not arguing to halt the law that protects patients from unexpected bills from providers they didn’t know were outside their insurance network. Instead, they want to change the rules for the mediators who will settle the dispute between insurers and providers.
The Health and Human Services secretary says the administration has heard complaints from doctors and hospitals about the rules it unveiled for implementing the law to end surprise medical bills. But he says providers who have exploited a complicated system to charge exorbitant rates will have to bear their share of the cost — or close.
Congress last year shielded consumers from unexpected out-of-network charges, but hospitals and doctors have decried the arbitration plan put forward by the Biden administration for negotiating these bills as favoring insurers. More than 150 members of the House agree.
Democratic negotiators on Capitol Hill appear to be nearing a compromise on President Joe Biden’s social spending agenda, spurred partly by Democratic losses on Election Day in Virginia. Meanwhile, the Supreme Court hints it might allow abortion providers to sue Texas over its restrictive new ban. But the relief, if it comes, could be short-lived if the court uses a second case, challenging a law in Mississippi, to weaken or overturn Roe v. Wade. Alice Miranda Ollstein of Politico, Margot Sanger-Katz of The New York Times and Mary Ellen McIntire of CQ Roll Call join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KHN’s Rae Ellen Bichell, who reported and wrote the latest KHN-NPR “Bill of the Month” feature about an emergency bill for a nonemergency birth.
Patients soon will not have to worry about the prospect of these often-costly unexpected bills, a federal law promises. Some experts say the new policy could also slow the growth of health insurance premiums.
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