Tag: Health Insurance and Managed Care

Top Official at Indian Health Service Will Step Down

The director of the Indian Health Service has said that he will resign, giving President-elect Joseph R. Biden Jr. a chance to install new leadership at an agency that has drawn intense criticism for its failures to provide adequate care to tribal communities both before and during the pandemic. The director, Rear Adm. Michael Weahkee, […]

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Disabled Americans Are Losing a Lifeline

At a time when the pandemic has hit the disabled and elderly the hardest, they also face the erosion of a critical income lifeline, Supplemental Security Income (S.S.I.). The program has collapsed during the pandemic: From July to November 2020, the Social Security Administration awarded benefits to about 100,000 fewer individuals compared with the same […]

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Biden Picks Dr. Nunez-Smith to Lead Health Equity Task Force

Growing up in the United States Virgin Islands, Dr. Marcella Nunez-Smith saw firsthand what can happen in a community with limited access to health care. Her father, Moleto “Bishop” Smith Sr., was only in his 40s when he suffered a debilitating stroke that left him partly paralyzed and with slurred speech. The cause was high […]

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With New Majority, Here’s What Democrats Can (and Can’t) Do on Health Care

Reducing drug prices The Democratic House’s other big recent health bill was an effort to lower the prices of certain expensive prescription drugs. Lowering drug prices has been a Democratic policy priority for many years, and one that Mr. Biden endorses, at least in general. President Trump has championed legislation on drug prices as well, […]

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Amazon, Berkshire and JPMorgan Will End Joint Health Care Venture

“Haven worked best as an incubator of ideas, a place to pilot, test and learn — and a way to share best practices across our companies,” Mr. Dimon added. Business & Economy Updated  Jan. 4, 2021, 3:39 p.m. ET Haven named Dr. Atul Gawande, a surgeon affiliated with Harvard Medical School and Boston’s Brigham and […]

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What It Takes to Heal From Covid-19

Over the past year, many of us have watched family and friends recover from the virus that ripped through our bodies. We have seen politicians who mocked mask mandates quickly recover after receiving experimental antibody treatments, even as many people were denied any treatment at all when they first became ill. We are angry. We […]

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Don’t Let the Pandemic Stop Your Shots

Experts fear that vaccination rates may have fallen further during the pandemic, as they have among children, if older people wary of going to doctors’ offices or pharmacies skipped shots. Financial and bureaucratic obstacles also thwart vaccination efforts. Medicare Part B covers three vaccines completely: influenza, pneumococcus and, when indicated, hepatitis B. The Tdap and […]

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Obamacare, in Its First Big Test as Safety Net, Is Holding Up So Far

In past recessions, the uninsured rate would surge. Now, for the first time, Americans are experiencing a recession with the Affordable Care Act in place. The health law’s expansion of Medicaid and its offer of subsidized health plans have provided a new safety net for those who have lost their jobs and their health insurance. […]

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Why Ambulances Are Exempt From the Surprise-Billing Ban

When Congress passed a new law banning surprise medical bills on Monday, it made a notable exception: ambulances. Ambulances have the highest out-of-network billing rate of any medical specialty, meaning most rides can result in a surprise bill. The new federal law will protect patients from the bills of out-of-network doctors unexpectedly involved in their […]

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Surprise Medical Bills Cost Americans Millions. Congress Is Finally Set to Ban Most of Them.

Hospitals and doctors, who tend to benefit from the current system, fought to defeat solutions that would lower their pay. Insurance companies and large insurers groups, on the other hand, have wanted a stronger ability to negotiate lower payments to the types of medical providers who can currently send patients surprise bills. Legislation nearly passed […]

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This Is the Health System That Biden Inherits From Trump

President-elect Joe Biden will inherit a health system that is trying to care for a population made sicker by both coronavirus and skipped preventive care, all while trying to make up for money lost in 2020. But he’ll face another immediate challenge: Hospitals that tend to care for the poor and the vulnerable are facing […]

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The Vaccines Are Supposed to Be Free. Surprise Bills Could Happen Anyway.

When Americans receive a coronavirus vaccine, federal rules say they shouldn’t have to pay anything out of pocket. Congress passed legislation this spring that bars insurers from applying any cost sharing, such as a co-payment or deductible. It layered on additional protections barring pharmacies, doctors and hospitals from billing patients. To consumer advocates, the rules […]

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Drug Makers Are Pulling Back From a Program to Help the Needy

WASHINGTON — Some of the nation’s top pharmaceutical companies have stopped giving federally mandated drug discounts to hospitals and clinics that care for the poorest Americans, a move that is prompting bipartisan calls for the health secretary, Alex M. Azar II, to demand reinstatement of the price breaks or punish the firms. The companies — […]

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It’s Not Just You: Picking a Health Insurance Plan Is Really Hard

“People want advice, they want guidance,” Mr. Lang said. “And it’s pretty hard.” The people most likely to make bad choices appear to be those least able to afford it. A recent study in the Netherlands, which offers insurance to everyone through an Obamacare-like marketplace, found that only 5 percent of Dutch customers did a […]

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Becerra Supports ‘Medicare for All,’ and Could Help States Get There

Xavier Becerra has long supported moving the United States to a “Medicare for all” system. As President-elect Joe Biden’s pick to run Health and Human Services, he may have opportunities to speed up such a transition. The Health and Human Services secretary oversees an array of waivers that states can use to cover new groups […]

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Covid Testing: What You Need to Know

What type of test should I get? Virus tests are categorized based on what they look for: molecular tests, which look for the virus’s genetic material, and antigen tests that look for viral proteins. The various tests all use a sample collected from the nose, throat or mouth that may be sent away to a […]

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Republicans Can’t Handle the Truth

President Trump’s continuing attempts to overturn an election he lost decisively more than a month ago is, like so much of what he’s done in office, shocking but not surprising. Who imagined that he would go quietly? What some people may not have been fully prepared for is the way Trump’s party as a whole […]

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ACA Open Enrollment: What If You Make Too Much for a Subsidy?

In general, it’s wise to be cautious when buying outside government marketplaces. The Government Accountability Office did a small study this summer using undercover agents who called 31 insurance salespeople. They found that while most brokers gave clear, honest information, two were confusing and eight were deceptive about the coverage in the plans they were […]

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Actors Sue SAG-AFTRA Health Plan Over Changes in Insurance

In August, hundreds of actors excoriated the health plan of the American union for professional television and film actors for changes that would result in some members no longer qualifying for health insurance, because they were unable to work during the pandemic. Now, 10 participants in the plan are suing, in a class-action filing. Ed […]

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Ex-Arizona Official Gets More Than 6 Years in Prison in Adoption Fraud Scheme

A former Arizona official was sentenced on Tuesday to more than six years in federal prison for running a multistate adoption fraud scheme that prosecutors said had preyed on women from the Marshall Islands and would-be foster parents in the United States who were eager to start families. The official, Paul D. Petersen, a Republican […]

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After 4 Years of Trump, Medicare and Medicaid Badly Need Attention

President-elect Joe Biden has pledged to “marshal the forces of science” in his administration. Undoubtedly he needs to start by bolstering the credibility of the Food and Drug Administration and the Centers for Disease Control and Prevention. But a third health agency, central to the lives of older Americans, low-income families and the disabled, is […]

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How US Hospitals Are Stretched Way Too Thin Due to Covid-19

In excruciating pain with lesions on her face and scalp, Tracey Fine lay for 13 hours on a gurney in an emergency room hallway. All around her, Covid-19 patients filled the beds of a hospital in Madison, Wis. Her nurse was so harried that she could not remember Ms. Fine’s condition, and the staff was […]

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Biden’s Plan for Seniors Is Not Just a Plan for Seniors

President-elect Joseph R. Biden Jr. has no shortage of ideas about how to transform caregiving. One striking feature of his team’s plan: It does not address elder care separately from child care, or divide plans to support family caregivers from those for paid caregivers. Rather, it takes on Medicaid benefits for older and disabled adults, […]

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When Churches Rescue Americans From Crushing Covid

Vanessa Matos couldn’t believe what she was reading. “I was like, OK, this is a scam,” she recalled of the letter she received in February. Her husband, she said, had the same reaction: “Yeah, this isn’t real.” But it was. Ms. Matos’s medical debt — more than $900 owed because of complications from surgery at […]

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Children in U.S. May Miss 9 Million Vaccine Doses in 2020, Report Warns

Children in the United States are on pace this year to miss nine million vaccine doses for measles, polio and other highly contagious diseases, according to medical claims data — a disruption that health care authorities called alarming and attributed to the coronavirus pandemic. The data was made public on Wednesday by the Blue Cross […]

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Obamacare Enrollment Opens, With Costs Generally Lower

If you’ve lost your job during the pandemic, and with it your health insurance, you may think that Obamacare plans are too expensive and therefore not worth seeking. Or maybe you’re worried about whether the coverage will withstand legal challenges. Think again, health care analysts say. Most people seeking insurance through Obamacare marketplaces qualify, based […]

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People Are Choosing Kidney Dialysis at H

Come January, there may be many more people like Mary Prochaska. Ms. Prochaska, 73, a retired social worker in Chapel Hill, N.C., has advanced chronic kidney disease and relies on dialysis to filter waste from her blood while she awaits a kidney transplant, her second. But she no longer visits a dialysis center three times […]

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Medicare’s Choices Have Grown, but Many Americans Don’t Review Options

This is the time of year when seniors face a barrage of messages about their Medicare coverage — everything from insurance companies’ direct mail blitzes and television ads to the federal government’s emails and mailings. All of it focuses on the fall open enrollment season, the annual opportunity to change coverage. From Oct. 15 until […]

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Covid-19 Threatens People With Intellectual and Developmental Challenges

People with intellectual disabilities and developmental disorders are three times more likely to die if they have Covid-19, the illness caused by the coronavirus, compared with others with the diagnosis, according to a large analysis of insurance claims data. The finding raises complex questions about how to allocate new vaccines as they become available in […]

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Now’s the Time to Sign Up for Health Insurance. Here’s How.

If you need health insurance, and can’t get it from your job, this is the time for you. It’s the season when anyone who wants a 2021 Obamacare health plan can shop for one. The waves of job losses caused by the pandemic have disrupted many people’s incomes and insurance arrangements. But even people whose […]

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