Stories


3 days Ago

Cut Consumer Costs – In Their Own Words

Cut Consumer Costs – In Their Own Words

Billing Error Results In $9K Bill For TN Consumer
3 days Ago

Billing Error Results In $9K Bill For TN Consumer

In March, Tennessean Mary Lynn Claridy had so much pain in her chest that she feared she might be having a heart attack. Claridy’s daughter rushed her to Sumner County Regional Medical Center’s emergency room. News Channel 5 reports that Claridy was admitted in to the hospital and physicians began performing tests to find out […]

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CA Health Giant Faces Class Action Suit
3 days Ago

CA Health Giant Faces Class Action Suit

As physician groups and hospitals continue to consolidate across the country, consumer advocates have cautioned what these deals could mean for consumers and their pocketbooks. Consumers for Quality Care has highlighted how hospital consolidation can lead to higher costs and worse health outcomes for consumers. Northern California’s Sutter Health, a leader in large scale hospital […]

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Telemedicine Increases Care Access For IN Consumers
3 days Ago

Telemedicine Increases Care Access For IN Consumers

Photo by Heidi de Marco/KHN Despite mandates in the Affordable Care Act, mental health care parity has continued to be a challenge. Consumers, especially those in rural areas, have struggled to access the mental health care that they need. Now, Indiana’s Meridian Health Services is using telepsychiatry to provide consumers greater access to care, NPR […]

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A Backyard Trip Results In Sling With A 900% Markup For CA Woman
3 days Ago

A Backyard Trip Results In Sling With A 900% Markup For CA Woman

After tripping over a hose in her backyard, Cathy Birker-Hake made her way to Providence St. Joseph Medical Center in Burbank, CA. The fall dislocated Birker-Hake’s shoulder. Emergency room physicians reset it and gave her a sling to keep her arm in place while it healed, according to the Los Angeles Times. “It was one […]

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Coding Error Results In Surprise Bill For CA Family
3 days Ago

Coding Error Results In Surprise Bill For CA Family

When Jobbie Spillane took her 17-year-old son to a Northern California Kaiser medical facility to have Botox injected into his salivary glands, she thought she knew how the visit would go. The procedure helps her son, who has a breathing condition, ward off pneumonia and other complications, Healthline reports. He had been getting the injections […]

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As Employer Costs Are Expected To Increase, GA University System Changes Policy For Spouses
3 days Ago

As Employer Costs Are Expected To Increase, GA University System Changes Policy For Spouses

Consumers and employers alike are beginning to look towards what their coverage options may look like for 2020. Some of this news, like a recent survey which found that fewer employers will offer high-deductible plans as their only insurance options, has been encouraging for consumers. But a new study suggesting that the cost of employer-sponsored […]

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Congress Should Focus On Surprise Billing
5 days Ago

Congress Should Focus On Surprise Billing

It is no secret that consumers are frustrated with surprise and balance medical bills. Research from Consumers for Quality Care and Ipsos found that 91 percent of consumers want to better understand the costs associated with their health care and 88 percent say that lowering out-of-pocket costs should be a top priority for lawmakers in […]

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Women, Minority Consumers Forced To Advocate Harder For Quality Care
5 days Ago

Women, Minority Consumers Forced To Advocate Harder For Quality Care

While consumers often seek medical care for the same reason – to improve their health and quality of life – their experiences can differ. Voice of America examines the role empathy plays in care and how women and minorities can be adversely affected. A 2007 study from the University of Tennessee – Chattanooga found that […]

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Consumers Turn To Different Kind Of Health Care Shopping
5 days Ago

Consumers Turn To Different Kind Of Health Care Shopping

Dr. Nicole Herbst, a medical fellow at Emory University, was befuddled when patients began walking into the emergency room with abnormal CT scans. The results were not the confusing part – the origin of the scans was. The patients had purchased them using Groupon, NPR reports. As consumers grapple with the high cost of medical […]

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NYT & Washington Post Spotlight How Hospitals Flourish While Consumers Struggle
1 week Ago

NYT & Washington Post Spotlight How Hospitals Flourish While Consumers Struggle

While hospitals have largely escaped the scrutiny of other health care players in recent years, they are “arguably a primary culprit behind runaway medical inflation,” writes Elisabeth Rosenthal, the editor in chief of Kaiser Health News, in a New York Times op-ed published earlier this month: Data shows that hospitals are by far the biggest […]

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Utah Consumers At High Risk Of Surprise Bills
1 week Ago

Utah Consumers At High Risk Of Surprise Bills

When William Potter’s daughter was hurt in horseback riding accident, her family had no choice in which hospital she went to. She was airlifted, while unconscious, to an emergency room for treatment. The facility was out of network for the Potters’ insurance, resulting in a massive surprise bill for the family, KUTV reports: Potter, who […]

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Bill For CT Consumer’s Hernia Repair More Than 50% Higher Than Estimate
1 week Ago

Bill For CT Consumer’s Hernia Repair More Than 50% Higher Than Estimate

Wolfgang Balzer did what experts recommend for effectively shopping for health care services. Balzer, who works as an engineer in Connecticut, had known for a number of years that he would need surgery to repair a hernia. In February 2018, his wife, Farren, gave birth to their second child. With the family having met their […]

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Doctors Often In The Dark About The Price Of Medication
1 week Ago

Doctors Often In The Dark About The Price Of Medication

When a doctor writes their patient a prescription, the goal is to improve the patient’s health and quality of life. Considerations like side effects or potential interactions with other treatments are often weighed in prescribing decisions. However, another important consideration is often missing: the price. Most consumers don’t know what their prescription will cost them […]

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Consumers Feel The Impact Of Medical Debt
1 week Ago

Consumers Feel The Impact Of Medical Debt

Joclyn Krevat was sitting at her computer in 2011 when she received a new LinkedIn request. Krevat recognized the name but was nonetheless baffled by the request. The woman who had sent it, Karen Pollack, was the head of the debt-collection practice KP Recovery Solutions and had been trying to collect from Krevat, The Atlantic […]

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Consumer Right To Appeal Turns 20 In Ohio
3 weeks Ago

Consumer Right To Appeal Turns 20 In Ohio

When consumers receive a bill from a hospital or doctor visit that they do not understand or disagree with, they have a right to appeal the charges. While the Affordable Care Act codified this right into federal law, it has been Ohio law since 1999, The Columbus Dispatch explains. “The consumer receives a denial or […]

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Rural MT Facilities Struggle To Maintain Staff, Provide Care
3 weeks Ago

Rural MT Facilities Struggle To Maintain Staff, Provide Care

Since it opened in 2002, the mental health unit in eastern Montana’s Glendive Medical Center unit has been empty much of the time. Even though the town has a small population of around 5,000, there’s no lack of need for mental health care as Montana has the highest suicide rate in the country. The region, […]

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John Oliver Highlights Bias in Medical Care
3 weeks Ago

John Oliver Highlights Bias in Medical Care

In a recent segment of his show Last Week Tonight, John Oliver explores how biases in medical care are harming consumers, Time reports. The segment examined how the treatment of women and minority patients can lead to worse health outcomes for those patients. According to Oliver, several studies have shown that bias among doctors leads […]

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Farah From Georgia Describes Her Frustration Over Having To Fight Her Insurance For Coverage
3 weeks Ago

Farah From Georgia Describes Her Frustration Over Having To Fight Her Insurance For Coverage

Farah from Georgia shares her frustration about becoming the go-between for the insurer and doctors. When her husband needed surgery and they were trying to make sure it would be covered, she spent several days figuring out the paperwork and on the phone. Farah from Georgia needed to quickly become an expert in medical coding […]

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Virginia From New York Shares Her Experience Fighting Hospital Bills
4 weeks Ago

Virginia From New York Shares Her Experience Fighting Hospital Bills

Virginia from New York was hit by a car while biking and went to the hospital to get treatment. The experience left her frustrated and fighting thousands of dollars in medical bills. After her biking accident landed her in the hospital, Virginia from New York was left fighting thousands of dollars in medical bills. She […]

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Therese From California Describes Treatment Delays Caused By Her Insurer
4 weeks Ago

Therese From California Describes Treatment Delays Caused By Her Insurer

After Therese from California fractured both of her feet, she was eager to recover as soon as possible but her insurer’s requirements for coverage delayed the process.

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Monica From Texas Shares Her Family’s Experience Receiving A Surprise Bill
4 weeks Ago

Monica From Texas Shares Her Family’s Experience Receiving A Surprise Bill

Monica from Texas described her family’s experience in getting surprise bills for a treatment for her husband’s autoimmune disease they were told was covered by their insurance.

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Melinda From Illinois Describes Her Experience With Surprise Bills
4 weeks Ago

Melinda From Illinois Describes Her Experience With Surprise Bills

Melinda from Illinois was diagnosed with breast cancer, and what was sure to be a stressful time for her and her loved ones was made even more stressful as she received high surprise bills as a result of out-of-network providers. As she was undergoing diagnosis and treatments for breast cancer, Melinda from Illinois made sure […]

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Jane From Illinois Shares Her Frustration Over Surprise Bills
4 weeks Ago

Jane From Illinois Shares Her Frustration Over Surprise Bills

When her 18-year-old son went to the ER, Jane from Illinois knew she might get a medical bill, but she was stunned when her insurance denied coverage for the entire visit. She has been on the phone with the company to provide them with the required documents but feels like she’s getting the runaround. As […]

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Hellen From Illinois Shares Her Frustration Over Her Insurance’s Outdated Directory
4 weeks Ago

Hellen From Illinois Shares Her Frustration Over Her Insurance’s Outdated Directory

Hellen from Illinois was experiencing foot pain and wanted to see a doctor to get a diagnosis. But when she tried to find a provider in her network, it took her a long time and many phone calls because of an outdated online directory.

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Aundria From Texas Describes Her Frustration With Insurance’s Slow Approval Process
4 weeks Ago

Aundria From Texas Describes Her Frustration With Insurance’s Slow Approval Process

After her father was diagnosed with cancer, Aundria from Texas had him move in with her, her husband and their young daughters. She has been taking care of him, juggling multiple doctor appointments, treatments and calls with insurers. Her biggest frustrations are the lack of clear communication between the insurer and physicians and the time […]

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Rural MO Consumers, Hospital Fight To Stay Afloat
4 weeks Ago

Rural MO Consumers, Hospital Fight To Stay Afloat

Like other hospitals around the country, Poplar Bluff Regional Medical Center in Missouri has been aggressively suing consumers over unpaid bills. This year alone, the medical center has filed more than 1,100 lawsuits in rural Missouri. Cases over unpaid bills have become so common that patients have started referring to the court appearances as “follow-up […]

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NJ Actor Fights Insurer For Coverage
4 weeks Ago

NJ Actor Fights Insurer For Coverage

Despite finding success as an actor, 28 year-old Steve Way is in a position all too familiar for many consumers. He is battling his insurance company after a string of denials. Way has a type of musical dystrophy so rare that he is the only documented case in the world. He needs around-the-clock assistance and […]

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CT Woman Receives Surprise Bill From Hospital She Did Not Visit
1 month Ago

CT Woman Receives Surprise Bill From Hospital She Did Not Visit

Ashley Stearns has a family history of multiple sclerosis (MS), so when she started suffering from leg weakness, muscle spasms, and vision issues her doctor suggested she get an MRI. Stearns’ doctor booked the imaging test at Evergreen Imaging in South Windsor, CT, WFSB reports. Initially, she had wanted to go to a less expensive […]

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Study Says Employers Will Offer More Health Care Options in 2020
1 month Ago

Study Says Employers Will Offer More Health Care Options in 2020

A new study has good news for consumers’ ability to enroll in affordable, quality health care plans. The National Business Group on Health’s (NBGH) annual survey found that fewer large, self-insured employers are going to offer high-deductible insurance plans as their only option, Modern Healthcare reports. Consumers for Quality Care has reported previously that high […]

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Centene Under Fire For Medicaid Practices
1 month Ago

Centene Under Fire For Medicaid Practices

Senator Bob Casey (D-PA) has criticized insurance giant Centene, calling it callous, The Dallas Morning News reports. The comments come after Casey met with Centene CEO Michael Neidorff to discuss the insurer’s handling of its Medicaid business. The Dallas Morning News previously reported that Centene’s Texas subsidiary denied life-sustaining care to sick and disabled children […]

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Cut Consumer Costs – In Their Own Words
1 month Ago

Cut Consumer Costs – In Their Own Words

American health care consumers are frequently frustrated by unexpected costs, a lack of clarity throughout the process of accessing care and other roadblocks when it comes to getting the care they need. Many have taken to social media to discuss their experiences with things like high deductibles, unexpected emergency room bills and other challenges. Here, […]

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MA City of 100,000 Grapples With Closure Of Only ER
1 month Ago

MA City of 100,000 Grapples With Closure Of Only ER

Katie Stanton has become well acquainted with her local emergency room in Quincy, MA. Stanton, who is epileptic and cannot drive, relies on the proximity of Quincy Medical Center’s ER from her house, just 2 miles away, The Patriot Ledger reports. “It’s a vital resource for me,” she said. “If I have a medical emergency, […]

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CT Scrutinizing Hospitals’ Activation Fees
1 month Ago

CT Scrutinizing Hospitals’ Activation Fees

Consumers in Connecticut may be charged a “trauma activation fee” if they arrive by ambulance at one of the twelve hospitals in the state. These charges can amount to thousands of dollars. The fees, which are charged by hospitals, are currently unregulated and mostly hidden from the public, according to The Middletown Press. These fees […]

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VA Woman Reacts To Balance Bill
1 month Ago

VA Woman Reacts To Balance Bill

Sallie Smith was in the midst of her summer routine, packing snacks and the swim bag for her kids, when an unexpected e-mail popped up in her inbox. The Virginia mom assumed that it was something from a doctor’s visit for one of her kids, NBC 12 reports. The last time Smith herself had been […]

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Community Rallies Behind OH Teen With Rare Disease
1 month Ago

Community Rallies Behind OH Teen With Rare Disease

Photo by Heidi de Marco/KHN In January 2018, 14 year-old Ella Golden was diagnosed with the rare autoimmune disorder PANDAS. The disease causes physical and behavioral symptoms and has caused Golden to suffer from severe anxiety, OCD and agoraphobia, according to WYTV. Golden’s symptoms have become so severe that she hasn’t left the house in […]

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CO Woman’s New Insurance Plan Comes With Narrow Network
1 month Ago

CO Woman’s New Insurance Plan Comes With Narrow Network

When Colorado resident Mary Bonser retired, she knew she needed an insurance policy to fill the gap between her employer-sponsored insurance and Medicare. So, she turned to the state’s ACA marketplace to select a plan, KOAA reports. Having worked in human resources, Bonser knew that she needed to be diligent about selecting the plan she […]

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Insurer Denies IL Woman’s MS Treatment
1 month Ago

Insurer Denies IL Woman’s MS Treatment

For a while, Ivy Marcucci was able to rationalize her sporadic symptoms. Her vision blurred and doubled as she sat in a movie theater with her parents. Her father, Jared, an emergency room physician, noticed his daughter squinting and realized that her eyes were not moving in tandem, The Chicago Tribune reports. He took Ivy […]

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CA Boy Denied Lifesaving Heart Surgery
1 month Ago

CA Boy Denied Lifesaving Heart Surgery

Noah Connally was born with a rare heart condition, and by the time he turned one, he had already undergone three separate heart surgeries. Now at 3 years old, he needs another lifesaving heart surgery, KTLA reports. Niccole and Sean Connally scheduled their son’s surgery at Boston Children’s Hospital. They were set to fly to […]

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MI Mom Battles Insurer For Her Daughter’s Heart Surgery
1 month Ago

MI Mom Battles Insurer For Her Daughter’s Heart Surgery

Jessica Fitzsimmons is desperate to get her 12-year-old daughter, Aiden, the heart surgery she needs. But she says that her insurer, Total Health Care, will not cover the surgery, WXYZ reports. Aiden was born with a heart defect. She had her first surgery when she was 2, but now she needs a second. Jessica says […]

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Doctors Worry New Anthem Policy Will Disrupt Care
1 month Ago

Doctors Worry New Anthem Policy Will Disrupt Care

Physicians are frustrated with Anthem over a new policy that will deny patients coverage for certain same-day follow-up office visits, according to Healthcare Dive. They say the policy, which could especially impact primary care doctors and some specialists, disrupts patients’ care. The change is the latest in a sequence of policies that have frustrated physicians […]

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NY Hospital Sending Increased Number Of Unpaid Bills To Court
1 month Ago

NY Hospital Sending Increased Number Of Unpaid Bills To Court

Glens Falls Hospital in New York is the latest to receive scrutiny over its legal actions against patients. The hospital is suing dozens of former patients in civil court over unpaid medical bills, The Post Star reports. The report comes after similar practices by hospitals in Maryland, Tennessee, and Virginia have been called into question. […]

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CA Woman’s Ultrasounds Prices Highlights Lack Of Transparency In Health Costs
1 month Ago

CA Woman’s Ultrasounds Prices Highlights Lack Of Transparency In Health Costs

When Mika Moore’s doctor thought she might have internal bleeding, she went to an Orange County medical center for a pair of ultrasounds, The Los Angeles Times reports. Mika and her wife, Jennifer, have insurance with Cigna and she went to an in-network facility. A few weeks after the tests, the couple received a bill […]

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GA Woman’s Cancer Care Caught Between Doctor’s Plans, Insurer Approvals
1 month Ago

GA Woman’s Cancer Care Caught Between Doctor’s Plans, Insurer Approvals

Photo by Heidi de Marco/KHN When Georgia resident Kim Lauerman, 57, was diagnosed with ovarian cancer, her physicians started her on chemotherapy and wanted her to begin taking Neuogen. The drug prevents infections and fever during chemotherapy. Lauerman’s insurance, Anthem Blue Cross, denied the medication, Associated Press reports. Physicians say insurance denials for consumers like […]

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PBM Denies CA Woman’s Cancer Treatment
1 month Ago

PBM Denies CA Woman’s Cancer Treatment

When Norma Smith found out that she had stage-three multiple myeloma, which had spread extensively and attacked her bone marrow, she wanted to start treatments immediately. Smith and her husband, Rodney, are both retired. The couple considered their $500 a month Anthem policy to be “very expensive” but “the best” coverage, according to the The […]

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Consumers Feel Relief From NH Medicaid Work Requirement Decision
2 months Ago

Consumers Feel Relief From NH Medicaid Work Requirement Decision

Sixty-three year old Diane Roberts has worked for decades hauling trash in Merrimack County, New Hampshire. She would wake up before the sun, driving her 1988 Chevy dump truck across the county. One day in 2015, Roberts fell out of the truck in a work accident, hitting her head on the cement below, Concord Monitor […]

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MD Hospital Criticized For Debt Collection Practices
2 months Ago

MD Hospital Criticized For Debt Collection Practices

John Hopkins Hospital has found itself under fire over its treatment of low-income patients after accusations that the hospital targets them for lawsuits to recoup unpaid medical debt, WAMU reports. The controversy comes shortly after similar reports about Methodist University Hospital in Memphis and Virginia’s Mary Washington Hospital. [M]edical workers and labor organizations rallied outside […]

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Fed Up With Medical Denials, MN Employer Switches Insurance Coverage
2 months Ago

Fed Up With Medical Denials, MN Employer Switches Insurance Coverage

Real estate developer Kelly Doran, along with his company’s 250 employees, were covered by Blue Cross and Blue Shield of Minnesota, when the insurer denied a routine scan his doctor had ordered. Doran, a lung cancer survivor, soon learned that he was not the only person at his company to have issues with the insurer, […]

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Carrie From Georgia Discusses Receiving Surprise Bill After A Mammogram
2 months Ago

Carrie From Georgia Discusses Receiving Surprise Bill After A Mammogram

Carrie from Georgia had a mammogram done every year and it was covered by her insurance. She recently needed to get a diagnostic mammogram as a follow up to the annual exam, and was left frustrated after she received a $400 surprise bill.

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Cristina From Florida Discusses Dealing With Medical Billing Errors
2 months Ago

Cristina From Florida Discusses Dealing With Medical Billing Errors

Cristina from Florida was left frustrated after her son’s visit to the emergency room for breathing problems ended with a medical billing error, multiple bills, and a back and forth between the hospital administrator and her insurer to have the visit covered Cristina from Florida described the long process of getting the medical billing error […]

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Elizabeth From Washington Discusses Her Struggle To Find An In-Network Doctor
2 months Ago

Elizabeth From Washington Discusses Her Struggle To Find An In-Network Doctor

Elizabeth from Washington described her struggle to find a doctor in her insurance network to get treatment for an eating disorder. She talked about her disappointment when she thought she found a provider and went in for an appointment only to have it turn out they also did not accept her insurance.

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Ashley From California Describes Her Family’s Struggles To Pay Mounting Medical Bills
2 months Ago

Ashley From California Describes Her Family’s Struggles To Pay Mounting Medical Bills

Ashley from California described her family’s financial struggles with managing mounting medical bills as her mother’s health has deteriorated. With her mother’s many hospital stays and difficulty getting insurance to cover procedures, including amputations and kidney failure, Ashley says “it just feels like insurance doesn’t care about you.”

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Ashishkumar From Illinois Describes Insurance Denying MRIs
2 months Ago

Ashishkumar From Illinois Describes Insurance Denying MRIs

Following a serious car accident, Ashishkumar from Illinois underwent multiple surgeries and needed regular MRIs to track his recovery. In the years since his accident, he has needed to go through multiple rounds of appeals with his insurer to get these tests covered.

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Arden From South Carolina Describes Receiving A Surprise Bill
2 months Ago

Arden From South Carolina Describes Receiving A Surprise Bill

Arden from South Carolina described her confusion after she received a surprise bill following a hospital visit. She spent time looking for other hospitals in the area that may be more affordable, but worries she may receive another surprise bill in the future.

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Amber From Texas Discusses When Her Insurance Stopped Covering Her Medication
2 months Ago

Amber From Texas Discusses When Her Insurance Stopped Covering Her Medication

Amber in Texas talked about her frustrating experience when her insurer stopped covering her Lupus medication. As she worked alongside her doctor to appeal her insurer’s decision, her disease flared up and she still feels the effects a year later.

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Tara From Texas Discusses Her Surprise Bill
2 months Ago

Tara From Texas Discusses Her Surprise Bill

Tara in Texas confirmed that the facility and provider were in-network with her insurance when she went in to have a post-miscarriage procedure. She shared her frustrating story of then receiving a $3,000 surprise bill because the anesthesiologist was out-of-network and how dealing with this unexpected financial hardship made the healing process that much harder […]

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Erika From Michigan Discusses Having Medical Bills Coded Incorrectly
2 months Ago

Erika From Michigan Discusses Having Medical Bills Coded Incorrectly

Erika in Michigan described her frustrating experience after her gallbladder surgery was coded incorrectly. It took her months of going back and forth between the insurer and hospital, including collections agency involvement, to get it resolved. Erika also expresses her frustration with the lack of clarity when it comes to the prices of services and […]

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CO Family Fights For Coverage Of Daughter’s Fatal Disease
2 months Ago

CO Family Fights For Coverage Of Daughter’s Fatal Disease

Nineteen-month-old Maisie Green has Type 1 Spinal Muscular Atrophy, a progressive terminal disease that attacks the body’s muscles. Ciji Green, Maisie’s mother, says that 95 percent of babies with the disease die from breathing complications before their second birthday, KJCT 8 reports. Maisie is currently being treated with Spinraza, a medication that slows the progression […]

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FL Woman Fights $343K Hospital Bill
2 months Ago

FL Woman Fights $343K Hospital Bill

Jennifer Talavea from Florida received a shocking bill after her twins spent time in the neonatal intensive care unit. Her insurance company said she would be required to pay $343,000 out-of-pocket, according to NBC 6. Talavera says that she was baffled how she would be able to both pay the bill and continue to prepare […]

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Poll Finds That Middle-class Consumers Feeling The Squeeze Of Health Costs
2 months Ago

Poll Finds That Middle-class Consumers Feeling The Squeeze Of Health Costs

As high deductible insurance plans have become increasingly common and Americans grapple with surprise medical bills and insurance denials, middle-class consumers are feeling the squeeze. According to a new analysis from The Los Angeles Times, financial pressure has increased consumers’ anger and resentment towards their health care. Brenda Bartlett has about $2,500 in medical debt […]

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TN Family Fights Insurance To Transfer Son To Children’s Hospital
2 months Ago

TN Family Fights Insurance To Transfer Son To Children’s Hospital

Ellie and Josh Ingle’s son, Crew, was born with Down syndrome and a respiratory condition that has left him connected to breathing tubes and under 24-hour care. Crew hasn’t been able to leave the hospital since he was born roughly 5 months ago. While his parents want to be able to bring Crew home, they […]

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Walk-in Clinic Refuses To See OH Girl Over Outstanding Balance
2 months Ago

Walk-in Clinic Refuses To See OH Girl Over Outstanding Balance

When Jessica Vance’s 8-year-old daughter fell sick with a cough and fever, she knew that a trip to the emergency room would result in a costly bill. Instead, the Deer Park, Ohio mother opted to take her daughter to The Little Clinic walk-in clinic inside a local Kroger grocery store, FOX 6 reports. When they […]

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NH Woman Sues Insurer Over Denial
2 months Ago

NH Woman Sues Insurer Over Denial

In 2017, Lancaster resident Carolyn Daigle was helping an elderly relative get out of the shower when she fell. After the accident, Daigle went to see her primary care physician, thinking that she had hyperextended her back, according to the Union Leader. At her doctor’s direction, Daigle took over the counter pain medication and started […]

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Dialysis Treatment Results In $540K Bill For MT Couple
2 months Ago

Dialysis Treatment Results In $540K Bill For MT Couple

When Sovereign Valentine finally made it to the hospital in Plains, Montana, he had been feeling run down for months. Valentine, who works as a personal trainer, had tried to change his workout and diet but continued to feel worse. On the day he went to the hospital, he couldn’t stop throwing up, NPR reports. […]

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MA Families Struggle To Pay For Cost Of Treatment
2 months Ago

MA Families Struggle To Pay For Cost Of Treatment

Photo by Heidi de Marco/KHN Tiffany Uttam’s son was nine years old when he suddenly fell ill. He was anxious and paranoid, unable to sleep without one of his parents, and too sick to go school. He developed verbal and physical tics. Uttam took her son to the emergency room, afraid that he was having […]

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MN and CA Consumers See Medical Debt Erased
2 months Ago

MN and CA Consumers See Medical Debt Erased

American consumers increasingly face significant amounts of medical debt. A recent report from West Health and Gallup found that American consumers borrowed $88 billion to pay towards the $3.7 trillion in national health care spending in 2017. As more and more consumers struggle with surprise bills and insurance denials, the significant, long-term financial hardships that […]

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Survey Finds VA Consumers Worry About Health Costs Despite Medicaid Expansion
2 months Ago

Survey Finds VA Consumers Worry About Health Costs Despite Medicaid Expansion

According to the Virginia Consumer Healthcare Experience State Survey conducted by Altarum, Virginia residents remain concerned with the cost of health care despite Medicaid expansion in the commonwealth. The survey found that more than half of Virginians had been burdened by the price of health care in the past year, the Richmond Times-Dispatch reports. Of […]

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Consumers’ Insurance Denial Appeals Often Go Their Way
2 months Ago

Consumers’ Insurance Denial Appeals Often Go Their Way

For many Americans, surprise medical bills have become a frustrating and painful reality of their health care experience. Today, roughly one in six emergency room visits result in a surprise medical bill. While surprise bills and medical debt can have significant impacts on consumers’ long-term financial health, many still do not appeal insurance denials. According […]

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Bills, Collections Calls Unwelcome Reminder For IL Sexual Assault Survivor
2 months Ago

Bills, Collections Calls Unwelcome Reminder For IL Sexual Assault Survivor

Erin was a recent graduate working three jobs and adjusting to her new life. One night, six years ago, she went out for a drink in Chicago’s Bucktown neighborhood, NPR reports. Erin talked with a man at the bar that night and woke up the next morning at home, her body aching and covered in […]

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WA Couple Faces Surprise Bill After Husband’s Back Surgery
2 months Ago

WA Couple Faces Surprise Bill After Husband’s Back Surgery

Monte and Kristy Jones thought they were being diligent when Monte needed back surgery for a bulging disk. Before scheduling the surgery, they talked to their insurance company to get prior approval and confirm they would not have any expenses beyond their co-pay, KREM 2 reports. “They said, ‘You’re approved, go ahead and schedule it,’ and that’s what […]

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New York Magazine’s The Cut Highlights Women’s Experience With “Broken” U.S. Health Care System
2 months Ago

New York Magazine’s The Cut Highlights Women’s Experience With “Broken” U.S. Health Care System

As more and more Americans struggle to get the quality care that they need, media attention is also increasingly highlighting consumers’ experiences. Facing larger financial burdens from their care, consumers are turning to sites like GoFundMe for relief and sometimes even skipping out on care. Medical debt has become the largest cause of personal bankruptcy […]

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NE Teen Fights Rare Cancer, Insurance Denial
2 months Ago

NE Teen Fights Rare Cancer, Insurance Denial

Braydon Yardley was at the end of his football season during his senior year of high school when he complained of stomach pains. Braydon had loved sports since he could walk and his mother, Renee Yardley, didn’t want him to miss his last game. After the season ended, Renee took Braydon to the doctor to […]

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OH Family Receives $900 Surprise Bill
2 months Ago

OH Family Receives $900 Surprise Bill

Jodi Creasap Gee and her family were getting settled after their move to the Cleveland area when her daughter came into the kitchen screaming with a cut on her foot, WOSU reports. “There was just a trail of blood behind her. Her foot’s all bloody and I’m going, ‘oh no.’ I don’t even know where […]

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Painful Shoulder Leads To $256 Surprise Bill For PA Woman
2 months Ago

Painful Shoulder Leads To $256 Surprise Bill For PA Woman

When 80-year-old “bowling queen” Kathleen DeRosa went to her doctor’s office, she was in the middle of her season with the Guys & Dolls League and her throwing shoulder was hurting her. She had seen her physician previously for a bowling injury and received a cortisone shot that cost a $10-copay, The Philadelphia Inquirer writes. […]

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Rural Consumers in Kansas and Across US Face Less Access To Care After Hospital Closures
2 months Ago

Rural Consumers in Kansas and Across US Face Less Access To Care After Hospital Closures

As rural hospitals across the country close, patients have had to find an alternative plan for their treatments, Kaiser Health News reports. Karen Endicott-Coyan, a 65 year-old woman with multiple myeloma, has to drive an hour from her home in Kansas to seek treatment. In 2018, Mercy Hospital Fort Scott faced possible closure and the […]

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TN Hospital Scrutinized For Lawsuits, Wage Garnishing
2 months Ago

TN Hospital Scrutinized For Lawsuits, Wage Garnishing

When Carrie Barrett arrived at the emergency room at Memphis’ Methodist University Hospital in 2007, she had a shortness of breath, tightness in her chest, swelling in her leg, and her toes were turning black. Barrett had a family history of high blood pressure and had been recently diagnosed with congestive heart failure. Doctors performed […]

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VA Hospital Under Scrutiny For Suing, Garnishing Wages Of Consumers
3 months Ago

VA Hospital Under Scrutiny For Suing, Garnishing Wages Of Consumers

Daisha Smith, a 24-year-old night shift worker at a home for the elderly, was sued by Mary Washington hospital, where she was hospitalized for two weeks in 2017 while uninsured, NPR reports. Smith says she was not even aware she had an unpaid medical bill until the hospital began garnishing her wages. Smith was not […]

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New Executive Order Aims At Greater Transparency
3 months Ago

New Executive Order Aims At Greater Transparency

Consumers know all too well how it can be virtually impossible to understand the price of care before a procedure, even in a non-emergency situation. Research from Consumers for Quality Care and Ipsos found that 91 percent of consumers want to better understand the costs associated with their care. Eighty-seven percent said that hospitals make […]

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PA Newspaper Helps Consumers Navigate Prior Authorization Process
3 months Ago

PA Newspaper Helps Consumers Navigate Prior Authorization Process

Consumers often need to receive prior  authorization before receiving medical care. The process, however, can be confusing and cumbersome. While the practice has been criticized, including by the American Medical Association, it is still required for many consumers. In a new article, The Philadelphia Inquirer helps consumers navigate the prior authorization process in order for […]

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Arkansas Medicaid Work Requirements Hurt Consumers
3 months Ago

Arkansas Medicaid Work Requirements Hurt Consumers

Photo by Heidi de Marco/KHN As more states have adopted Medicaid work requirements, CQC and other consumer advocates have warned about the potential harmful consequences for some of the nation’s most vulnerable populations. A new study highlights the program’s shortcomings in Arkansas, which was the first state in the nation to implement such requirements, Kaiser […]

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Study Shows High Prevalence Of Surprise Bills
3 months Ago

Study Shows High Prevalence Of Surprise Bills

A new study from the Kaiser Family Foundation highlights how prevalent surprise bills have become for American consumers. KFF found that nearly 1 in 6 insured consumers received a surprise bill after being treated at a hospital in 2017, according to Kaiser Health News. The study found that an average of 16 percent of inpatient […]

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Program Aims To Provide Help, Health Education To WY Residents
3 months Ago

Program Aims To Provide Help, Health Education To WY Residents

Photo by Heidi de Marco/KHN Gary and Celeste Havener spend much of their time growing vegetables and horseback riding on their land in southeast Wyoming, 40 miles outside of Laramie. When Celeste recently fell off her horse, she lay on the ground trying to assess how hurt she was. At the same time, she was […]

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CA Warns Insurers About Discriminatory HIV Prevention Denials
3 months Ago

CA Warns Insurers About Discriminatory HIV Prevention Denials

California’s Department of Insurance recently issued a warning to insurance companies that have denied policies to consumers taking HIV-preventative medication, The Los Angeles Times reports. The warning comes after an investigation, which started in early 2018. The investigation found that a number of insurance companies had “denied, limited or charged higher rates for life, disability […]

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NJ Twins Need New Hearts And Lots Of Generosity
3 months Ago

NJ Twins Need New Hearts And Lots Of Generosity

24-year-old twins Edwin and Edward Roman each need a new heart and a lot of generosity. The Romans have already had surgeries costing more than $2 million. The twins have cardiomyopathy, a condition that causes the muscles in the heart to enlarge and harden, which restricts its ability to pump blood through the body. The […]

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Small Error Leads To Surprise Bill For TX Woman
3 months Ago

Small Error Leads To Surprise Bill For TX Woman

Earlier this year, severe stomach pain sent Dawn Roberts to the hospital. Roberts says she was careful to make sure she went to an in-network facility, so she chose Baptist Hospital. The hospital kept Roberts overnight and gave her a CT scan, according to News 4 San Antonio. Roberts said she thought she would be […]

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CA Man Wrestles With Billing “Misinformation” Given At Hospital
3 months Ago

CA Man Wrestles With Billing “Misinformation” Given At Hospital

When Joe Garber went to a Los Angeles area emergency room, he didn’t know how much it would cost but he knew it had the potential to be very expensive. Not wanting to take too many chances, Garber asked the ER staff what his tests would cost, he recounts in HuffPost. He couldn’t get any […]

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Horrific Accident, Son’s Injuries Spark TX Dad’s Efforts To Help Other Consumer In Need
3 months Ago

Horrific Accident, Son’s Injuries Spark TX Dad’s Efforts To Help Other Consumer In Need

Tim Allen was driving his 7-year-old son Will home after his little league practice when another car collided head-on with their truck. Tim pulled himself out of the vehicle and collapsed. When he saw Will still trapped in the truck, he thought he had lost his son, HuffPost reports as part of its “Life and […]

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“Ghost Networks” Hurt Vulnerable Consumers
3 months Ago

“Ghost Networks” Hurt Vulnerable Consumers

Jack Turban was training to be a psychiatrist when a senior doctor said that he should have a therapist too. Understanding himself better would only increase his ability to help his patients, the doctor explained to Turban. However, when Jack took the advice to heart and began calling around to in-network providers he found a […]

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PA Consumers Face Unexpected Medical Bills
3 months Ago

PA Consumers Face Unexpected Medical Bills

Emily Christian-Michaels was 20 weeks pregnant when she went to UPMC Magee-Womens Hospital in Pittsburgh for a routine scan. Unbeknownst to Christian-Michaels, the hospital instead performed an extensive scan. It was not covered by her insurance and resulted in an unexpected $1,900 bill, according to Trib Live. Christian-Michaels appealed the bill twice and was denied […]

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USVI Medical Professionals Turn To GoFundMe To Help With Medical Bills
3 months Ago

USVI Medical Professionals Turn To GoFundMe To Help With Medical Bills

In the latest installment of its “Life and Debt” series on consumers who turn to GoFundMe to help pay for medical care, HuffPost highlights the story of Kirstyn and Mark Livingston. Both work in health care; Mark is a family physician and Kirstyn is a psychologist. They work and live, with their two children, in […]

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Nile From Florida Discusses Cancellation of Her Daughter’s Insurance
3 months Ago

Nile From Florida Discusses Cancellation of Her Daughter’s Insurance

Nile took her six-month-old daughter to get her routine shots at the hospital. When she got there, she was surprised to learn her insurer had canceled her daughter’s insurance without any prior notice. Watch the video below to hear her story.

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Michelle From Florida Discusses Her Attempt to Get Insurance Pre-Authorization for Prescribed Medication
3 months Ago

Michelle From Florida Discusses Her Attempt to Get Insurance Pre-Authorization for Prescribed Medication

Michelle is a Floridian who had to fight with her insurer to get approval for a medication that her doctor prescribed. She tells her story in this video. Michelle from Florida shared her frustration over having to fight with her insurer to get her doctor-prescribed medication covered.

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Lisa From Florida Discusses Her Surprise Bill
3 months Ago

Lisa From Florida Discusses Her Surprise Bill

Lisa from Florida received a confusing, surprise bill from the hospital after receiving emergency surgery. Hear her story, told in her own words.

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Back Surgery Leads To $94K Bill For TX Woman
3 months Ago

Back Surgery Leads To $94K Bill For TX Woman

For as long as 26-year-old Liv Cannon can remember, she has dealt with pain. Chronic pain in her back and legs have limited what she can do and imposed what she came to accept as her new normal, Kaiser Health News reports. No doctor had even been able to explain the cause of her pain. […]

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CO Woman Fights $11K Bill
3 months Ago

CO Woman Fights $11K Bill

The morning she was due to fly home after a Las Vegas work convention, Colorado resident Cristina Ford began to experience contractions, The Denver Channel reports. “When I called the doctor, what was alarming was that the contractions were very consistent, they were not Braxton Hicks,” she said. “She said, ‘Absolutely do not get on […]

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One in Six Women Mistreated During Child Birth
3 months Ago

One in Six Women Mistreated During Child Birth

Tanefer Camara had every intention of giving birth in the hospital. When she went into labor at 38 weeks, she called her midwife, who told Camara to wait a while longer at home even though Camara thought it was time to go to the hospital, Vox reports. Camara’s labor progressed quickly. Sprawled out on her […]

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Utah Family Fights for Son’s Care After Insurance Denial
3 months Ago

Utah Family Fights for Son’s Care After Insurance Denial

Last August, the police showed up at Leah’s home in Utah. Her son had texted his friends that he was going to take his own life, so they had used the Safe Utah app to notify the police, KUTV reports. Leah took her son to his longtime doctor. The doctor told Leah that he should […]

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OH & KS Consumers Sue Insurance Company Over Flimsy Plans
3 months Ago

OH & KS Consumers Sue Insurance Company Over Flimsy Plans

After her divorce in 2016, Ohioan Elizabeth Belin shopped around for an ACA plan. Belin says she spoke to a broker who told her he would find a plan that fit her budget. Belin was not told, however, that the plan she purchased was actually a plan with limited coverage, The New York Times reports. […]

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Debt Collector Targets PA Woman For Already Paid Bills
3 months Ago

Debt Collector Targets PA Woman For Already Paid Bills

In 2017, Judy Politzer went to Crozer-Keystone Health System to have a colonoscopy. When she received her bill from the hospital it included a charge for anesthesia, which Politzer had not received. She spent months trying to resolve the billing issue to no avail. During that period, the bill was sent to collections. Finally, she […]

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Family Of CO Boy Finds Success Crowdsourcing To Pay For Medical Care, But More Is Needed
3 months Ago

Family Of CO Boy Finds Success Crowdsourcing To Pay For Medical Care, But More Is Needed

Maxwell Freed, a 2-year-old, has a genetic disorder so rare that it is only known by the name of the gene it affects, SLC6A1. Maxwell, who lives in Denver, is among 50 people known to have the disease globally, HuffPost reports. SLC6A1 could leave Maxwell “with permanent, severe intellectual and developmental disabilities, and a form […]

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Insurer Denies Coverage For PA Woman’s Insulin
3 months Ago

Insurer Denies Coverage For PA Woman’s Insulin

As a Type 1 diabetic, Sharon Pennock needs insulin to live. Recently, her physician decided that her insulin prescription needed to be adjusted; she needed one more vial per month than her previous prescription allotted, KYW reports. When Pennock went to pick up the medicine at a Philadelphia-area pharmacy, she was shocked by what happened […]

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State, Federal Governments Loosen Short-Term Health Policy Regulations, Put Oklahoma Consumers At Risk
3 months Ago

State, Federal Governments Loosen Short-Term Health Policy Regulations, Put Oklahoma Consumers At Risk

As consumers look for affordable health care, short-term limited-duration insurance plans can often seem attractive. However, these policies often leave individuals vulnerable, with coverage gaps and the potential for expensive surprise bills. Actions taken by both the federal government and the Oklahoma legislature may leave consumers in the state even more susceptible to the negative […]

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GA Consumers Face Anxiety Over Cost of Cancer Treatments
3 months Ago

GA Consumers Face Anxiety Over Cost of Cancer Treatments

Lack of transparency, high deductibles, coverage denials and confusing provider-networks often leave consumers seeking to obtain the care they need with financial burdens. As Consumers for Quality Care has highlighted, even those with the most detailed understanding of how the country’s health care system works can face unforeseen costs. Thomas Lyles says there was a […]

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CO Paper Highlights Consumers’ Struggle To Obtain Mental Health Care
3 months Ago

CO Paper Highlights Consumers’ Struggle To Obtain Mental Health Care

As part of a yearlong investigative series, The Colorado Springs Gazette is highlighting consumers’ struggle to grapple with gaps in Colorado’s mental health care system. The series, “Mental Health: A Crisis in Colorado,” examines issues impacting Coloradans’ ability to get the mental health care they need, The Gazette reports. Despite 300 annual days of sun, […]

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Cut Consumer Costs – In Their Own Words
3 months Ago

Cut Consumer Costs – In Their Own Words

American health care consumers are frequently frustrated by unexpected costs, a lack of clarity throughout the process of accessing care and other roadblocks when it comes to getting the health care they need. Many have taken to social media to discuss their experiences with things like high deductibles, unexpected emergency room bills and other challenges. […]

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Family Faces Thousands In Medical Bills, Even After Infant Son’s Death
3 months Ago

Family Faces Thousands In Medical Bills, Even After Infant Son’s Death

When Elle Cavatore found out she was pregnant at 38, she was working in human resources and had good insurance. But shortly into her pregnancy, doctors found out that her twins were monochorionic-monoamniotic, meaning they were growing in a shared amniotic sac. The twins were so close in the womb that Elle’s obstetrician initially thought […]

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TX Woman Faces Surprise Bill
3 months Ago

TX Woman Faces Surprise Bill

When Yvonne Nassar’s primary care physician told her to go to the emergency room due to chest pains, she listened. Nassar knew that she needed to be careful about going to a facility that was in her insurer’s network, News 4 San Antonio reports. Earlier this year, Blue Cross Blue Shield of Texas’ network became […]

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Poll Shows Americans Skipping Care Due To Cost
3 months Ago

Poll Shows Americans Skipping Care Due To Cost

By Heidi de Marco/KHN A new survey from Monmouth University shows that Americans continue to skip needed medical care due to cost, The Hill reports. According to the survey, more than a quarter of respondents admitted that they had not sought treatment because they did not believe they could afford it. Additionally, 45 percent of […]

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Expecting Couple Fights Surprise Coverage Cancelation
3 months Ago

Expecting Couple Fights Surprise Coverage Cancelation

Caitlin and Corey Gaffer were shocked when they opened their mail, last October, to a notice saying the insurance they had been covered by for two years had been canceled, Kaiser Health News reports. The couple was in the middle of their first pregnancy. The couple thought they had paid their premium, as they did […]

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Freestanding ERs Have Unforeseen Issues For Consumers
3 months Ago

Freestanding ERs Have Unforeseen Issues For Consumers

Texas’ WFAA is urging consumers to better understand the difference between freestanding emergency rooms and urgent care centers. Texas has more than 200 freestanding emergency rooms, which often seem like an attractive care facility, offering short wait times and spacious facilities in convenient locations. However, seeking care at a freestanding ER can have costly, unforeseen […]

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First, A Brutal Attack. 7 Years Later, A Surprise Medical Bill
3 months Ago

First, A Brutal Attack. 7 Years Later, A Surprise Medical Bill

Dec 18, 2011 started like any other day for Yue “Alex” Kui Cen. He and his wife, Phuong Ly Cen, owned and operated a convenient store in Miami. Both are immigrants who “worked around the clock to build a humble existence” for their family, the Miami Herald reports. Everything changed on a December day when […]

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Proposed Rule Could Change Medical Debt Collections
3 months Ago

Proposed Rule Could Change Medical Debt Collections

Consumers for Quality Care has highlighted the stories of consumers who have faced the most severe consequences of surprise bills and medical debt, like home liens. Now, NPR reports that federal regulators are proposing a rule change that would impact how debt collectors can contact consumers about these debts. These changes could impact how consumers […]

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Florida Health Care Reporter Shares Her Experience With Cancer Treatment
3 months Ago

Florida Health Care Reporter Shares Her Experience With Cancer Treatment

It is no secret that the health care system can often feel daunting for consumers. Research conducted by Consumers for Quality Care found that 91 percent of respondents wanted to better understand the costs of their health care; 87 percent said it is difficult to get itemized bills from hospitals; and 75 percent said medical […]

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North Carolina Children’s Hospital Grapples With Bad Outcomes For Cardiac Surgery Patients
3 months Ago

North Carolina Children’s Hospital Grapples With Bad Outcomes For Cardiac Surgery Patients

In a recent article, The New York Times reported on physicians at North Carolina Children’s Hospital who grappled with declining outcomes for their cardiology patients. In 2016, after a number of children were faring worse than the physicians had expected them to, the doctors fought to find what was happening and questioned what care they […]

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News Study Shows Reporting Differences For Minority Hospital Patients
3 months Ago

News Study Shows Reporting Differences For Minority Hospital Patients

New research suggests that hospital staff were significantly more likely to report events that were harmful to patients when the individual in question was white, according to Modern Healthcare. The study, published in the Journal of Patient Safety, found that while white patients made up of 39.8 percent of the studied hospital system’s patient base, […]

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MS Doctor Denied Cancer Treatment
3 months Ago

MS Doctor Denied Cancer Treatment

Bryan and Lauren Hierlmeier did not expect to stay forever in Mississippi when they moved to the state for Bryan’s residency at the University of Mississippi Medical Center (UMMC). The couple fell in love with the state and Bryan ultimately decided to accept a job as a cardiac anesthesiologist at the hospital, according to the […]

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AZ Mom Fights Surprise Bill
3 months Ago

AZ Mom Fights Surprise Bill

Sarah Wilson feels blessed to have her new son, Ethan, in her life, and says that they both are happy. Except for one thing – Wilson has to fight a surprise bill that resulted from his birth, ABC 15 reports. Wilson’s physician told her that she needed a caesarian section. Before having the surgery, she […]

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Laughing Gas For Delivery Results In Nearly $5K Bill
3 months Ago

Laughing Gas For Delivery Results In Nearly $5K Bill

When Karli-Rae Kerrschneider was preparing for her own delivery, she wanted to have as comfortable of an experience as the patients she helps as a midwife. Kerrschneider had an epidural for the birth of her daughter in 2016, but she didn’t like that it confined her to the bed for labor, NPR reports. So, last […]

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$2 Mistake Leads To $1,300 Surprise Bill for Texas Family
3 months Ago

$2 Mistake Leads To $1,300 Surprise Bill for Texas Family

Isaac Chukkula was days away from his first birthday when he became ill. When he started to develop breathing problems, his parents Paulette and Kishore decided to take him to the emergency room, CBS reports. Isaac spent two days in the hospital being treated for bronchiolitis. A year later, Isaac’s hospitalization felt like a distant […]

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Insurer Denies 5-Year-Old’s Brain Surgery
3 months Ago

Insurer Denies 5-Year-Old’s Brain Surgery

5-year-old Berkeley Daniels is not able to run and play the way other children do. Berkeley has a rare genetic disorder, Dystonia 28. The disease has fewer than 100 reported cases worldwide, Fox 12 reports. It makes Berkeley’s muscles contract involuntarily and affects her ability to speak, eat, and walk independently.  Dystonia 28 is degenerative […]

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Study Shows Employer-Sponsored Insurance A Growing Burden For Consumers
4 months Ago

Study Shows Employer-Sponsored Insurance A Growing Burden For Consumers

A new study from the Commonwealth Fund highlights how employer-sponsored health insurance plans have become a growing burden for consumers, according to The Inquirer. Roughly 150 million Americans receive health insurance through their employer, making it the most common type of health insurance for individuals under 65-years-old. The study found that millions who receive their […]

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TX Man’s $7K Surprise Bill Reduced
4 months Ago

TX Man’s $7K Surprise Bill Reduced

In a recent installment of News 4 San Antonio’s “Show Me Your Bill” program, reporter Jaie Avila helped San Antonio resident Bill Vick reduce his surprise emergency room bill by $7,000. Vick pays $300 a month for his insurance, which he got through the ACA marketplace. Vick admits he knew his insurance was limited. Vick […]

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Rural Consumers Face Financial Insecurity, Lack Of Access To Health Care
4 months Ago

Rural Consumers Face Financial Insecurity, Lack Of Access To Health Care

A new poll from NPR highlights the financial insecurity and lack of access to health care that many consumers are facing. The findings, which come from two surveys NPR conducted with the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, highlight some of the challenges rural Americans face. While the […]

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TX Woman Describes Fight With Insurer, State
4 months Ago

TX Woman Describes Fight With Insurer, State

34-year-old Brittany Parsons woke up the morning of February 24, 2018 with a rash and unfamiliar leg pain. The pain increased throughout the day and by the time she put her kids to bed, she could barely walk. Her temperature spiked to nearly 104. Parsons’ doctor told her to get to emergency room immediately and […]

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Mental Health Month Highlights Consumers’ Mental Health Care Needs
4 months Ago

Mental Health Month Highlights Consumers’ Mental Health Care Needs

May is Mental Health Month and with it has come a number of stories and studies highlighting the rising need for mental health care. Alongside this increased need is a lack of access to the care Americans need and the challenges many face in getting insurance to cover mental health care. According to STAT, new […]

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Consumers Should Stand Up To Denied Medical Claims
4 months Ago

Consumers Should Stand Up To Denied Medical Claims

Photo by Heidi de Marco/KHN Consumers for Quality Care regularly highlights individuals who have battled with their insurance companies over denied medical claims. It seems, now more than ever, consumers are struggling to get the care they need covered by their insurers. It is not unusual for consumers to believe that their care will be […]

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Insurer’s Confusing Website Leads To $3,600 Surprise Bill
4 months Ago

Insurer’s Confusing Website Leads To $3,600 Surprise Bill

Amanda Bienek is a busy single-mother who runs a daycare out of her home. Still, she finds the time to look after her health. When she went to have her annual mammogram, it showed possible calcifications and Bienek scheduled a breast biopsy at her doctor’s recommendation, News 4 San Antonio reports. Bienek scheduled the procedure […]

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AZ Student Fights for Medical Records
4 months Ago

AZ Student Fights for Medical Records

Caitlin Secrist went to a renowned specialist at John Hopkins after her rare form of pancreatitis failed to respond to numerous other treatments. She wanted to have her pancreas removed, in a radical treatment, according to AZ Central. The physician told Secrist to make sure he was performing the correct surgery, he needed to see […]

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Cancer Patient Describes “Scary” Medication Denial
4 months Ago

Cancer Patient Describes “Scary” Medication Denial

Charlotte Ortiz’s health declined quickly. In January, she was healthy enough to pass a fitness assessment for her job with the National Guard and ice skate with her daughter. But by mid-February she was hospitalized with severe backpain, Columbus Dispatch reports. At the hospital, her health deteriorated even further. First, she suffered paralysis from the […]

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Physician Describes Arizona Family’s Fear of Medical Cost
4 months Ago

Physician Describes Arizona Family’s Fear of Medical Cost

An Arizona physician described his experience pushing back against a patient experiencing an emergency and his mother, who was afraid to receive medical care out of a fear of cost, to KJZZ. Mayo Clinic neurologist, Dr. Joseph Sirven, says he was working in a free clinic when a young patient started to have a seizure. […]

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Study Finds Work Requirements Likely Hurt Chronically Ill
4 months Ago

Study Finds Work Requirements Likely Hurt Chronically Ill

Photo by Heidi de Marco/KHN A new study published in Health Affairs suggests that states that have enacted Medicaid work requirements for adults are making it more difficult for those with chronic health conditions to retain coverage, which in turn makes it more difficult for them to work, according to Reuters. The study, which examined […]

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Rural Hospitals Face Uncertainty, Closure
4 months Ago

Rural Hospitals Face Uncertainty, Closure

When Fairfax Community Hospital’s remaining staff was summoned to CEO Tina Steele’s office, there was only about $12,000 left in the bank. Under normal circumstances, that $12,000 would keep the Oklahoma hospital running for a few hours. For months, the hospital had been running out of supplies. Paychecks hadn’t been issued in nearly 3 months. […]

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Cut Consumer Costs – In Their Own Words
4 months Ago

Cut Consumer Costs – In Their Own Words

American health care consumers are frequently frustrated by unexpected costs, a lack of clarity throughout the process of accessing care and other roadblocks when it comes to getting the health care they need. Many have taken to social media to discuss their experiences with things like high deductibles, unexpected emergency room bills and other challenges. […]

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New Report Highlights Medicaid Transparency Concerns
4 months Ago

New Report Highlights Medicaid Transparency Concerns

The Government Accountability Office released a report that raises concerns with a lack of transparency around major Medicaid changes, Modern Healthcare reports. According to the report, Medicaid has limited transparency concerning states’ rule changes, which impact enrollees. The government watchdog noted that two of the four states it studied did not seek public comment on […]

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Bipartisan Legislation Aims To Shield Consumers From Surprise Bills
4 months Ago

Bipartisan Legislation Aims To Shield Consumers From Surprise Bills

After continued attention on surprise and balance bills, congressional leaders have introduced bipartisan legislation to address the problem. The legislation marks the federal government’s most substantial efforts to curb surprise billing. The new bill, introduced by House Energy and Commerce Committee’s Chairman Rep. Frank Pallone (D-NJ) and Ranking Member Rep. Greg Walden (R-OR), aims to […]

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Fear Of Surprise Bills Leaves Mom Sitting In ER Parking Lot
4 months Ago

Fear Of Surprise Bills Leaves Mom Sitting In ER Parking Lot

Two years ago, Lindsay Clark’s 2-year-old daughter, Lily, got into a bottle of Dramamine despite the child-lock. Clark says she swept her finger through Lily’s mouth, but she wasn’t sure how many pills she had already eaten. Trying to determine what to do next, Clark called poison control, Sarah Kliff write for Vox. Clark had […]

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New Analysis Suggests Solutions For Ending Surprise Billing
4 months Ago

New Analysis Suggests Solutions For Ending Surprise Billing

As consumers continue to receive surprise bills, a new analysis from The USC – Brookings Schaeffer Initiative for Health Policy is examining how the current provider network adequacy standards fail to protect consumers from these surprise expenses and why legislation alone may not be enough to fix the problem. First designed in the mid-1990’s, provider […]

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Report Highlights Insurance Denials In MN
4 months Ago

Report Highlights Insurance Denials In MN

In a new investigation, Minnesota’s KSTP highlights a pattern of insurance companies denying coverage for consumers seeking care for mental illnesses. Consumers for Quality Care has previously highlighted how lack of mental health parity can hurt consumers. KSTP’s story comes during Mental Health Month and after a review of medical, state and court records found […]

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Boat Accident Results In Over $165K In Surprise Bills
4 months Ago

Boat Accident Results In Over $165K In Surprise Bills

Bob Ensor was cleaning a sailboat when the boom swung violently and hit him in the face, Kaiser Health News reports. Ensor was taken by ambulance to Riverview Medical Center near his Middletown, N.J. home. At the hospital, X-rays revealed he had broken his nose and several bones in his left eye socket. Ensor was […]

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More Consumers Have Their Medical Debt Erased
5 months Ago

More Consumers Have Their Medical Debt Erased

Shortly after Consumers for Quality Care highlighted a story about a Tennessee news station helping eliminate consumers’ medical debt, consumers in Kansas learned that their debt was also paid off. KWCH reports that $2.2 million of Kansans’ medical debt has been eliminated. Pathway Church in Wichita worked with RIP Medical Debt to pay off the […]

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Whistleblowers Allege Illegal Tactics Pushed Sales Of Drug With 97,000% Price Increase
5 months Ago

Whistleblowers Allege Illegal Tactics Pushed Sales Of Drug With 97,000% Price Increase

Documents recently unsealed in federal court recount accusations by two whistleblowers that by Questcor Pharmaceuticals, now Mallinckrodt, had a “multi-tiered strategy” to boost the sales of H.P. Acthar Gel at all costs, including bribing doctors and lying to the F.D.A., CNN reports. H.P. Acthar Gel is best known for treating a rare infant seizure disorder. […]

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Preventive Care Leads To Surprise Bill
5 months Ago

Preventive Care Leads To Surprise Bill

When Fan Fan Wainer went to her doctor for an annual check-up, she thought it would be fully covered by her insurance. Most health plans are required to provide preventive services free of charge under the Affordable Care Act. So when she received a bill for $98, she thought it was a mistake, WOOD TV […]

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Pharmaceutical Billionaire Sued For Killing A Cheap Cancer Drug
5 months Ago

Pharmaceutical Billionaire Sued For Killing A Cheap Cancer Drug

Photo by Heidi de Marco/KHN Pharmaceutical billionaire and media mogul Patrick Soon-Shiong is facing two lawsuits for allegedly creating a “catch and kill” scheme on a promising cancer treatment, Observer reports. “Catch and kill” schemes hurt consumers’ ability to get the medication they need at a lower cost by thwarting competition. According to Sorrento Therapeutics’ […]

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CMS Finalizes NBPP Rule, Limiting Copay Accumulators, Increasing Premium Adjustment Percentage
5 months Ago

CMS Finalizes NBPP Rule, Limiting Copay Accumulators, Increasing Premium Adjustment Percentage

Photo by Heidi de Marco/KHN CMS has finalized the 2020 Notice of Benefit and Payment Parameters rule (NBPP), which provides insurance companies with guidelines to create their 2020 plans. The rule, amongst other things, continues automatic reenrollment, limits the instances that insurers are allowed to use copay accumulator programs,  and increases the premium adjustment percentage, […]

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TX Consumer’s Hospital Bill Reduced By $22K
5 months Ago

TX Consumer’s Hospital Bill Reduced By $22K

News 4 San Antonio’s Jaie Avila is launching a new initiative, “Show Me Your Bill.” With the program, Avila hopes to help consumers like Lavera Vincent fight back against surprise medical bills. Before Vincent went to the emergency room for chest pains, she called ahead to confirm that the provider took her insurance, Allied National. […]

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Even With Insurance, Family Faces $15K In Medical Debt
5 months Ago

Even With Insurance, Family Faces $15K In Medical Debt

Clarisa and Zack Corber, both 33, have a list of hopes for their young family. Clarisa wishes she could get medication for her depression and acne. Zack needs to see a doctor about his knees, which swell after he climbs too many stairs. They wish they could move their family to a larger home, in […]

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Consumers Feel The Pressure Of High Deductible Plans
5 months Ago

Consumers Feel The Pressure Of High Deductible Plans

Consumers are feeling the squeeze as the deductibles associated with many employer-based health insurance plans continue to rise, the Los Angeles Times reports. In a new nationwide poll, the Times and Kaiser Family Foundation (KFF) examined employer-based health insurance plans and their impact on consumers. The research found that increasing deductibles and medical bills are […]

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Analysis Shows Huge Price Variations In Blood Tests
5 months Ago

Analysis Shows Huge Price Variations In Blood Tests

What should a metabolic blood panel, one of the most common medical tests, cost? How much will a consumer end up paying for the test? Unfortunately for consumers, both of these questions are often unanswerable according to a new analysis. The study, reported by The New York Times, highlights the overwhelming price fluctuations in health […]

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Same Insurance, Same Hospital, Different Bills
5 months Ago

Same Insurance, Same Hospital, Different Bills

Layla Parast and Erin Tylor felt lucky to have each other when they both were pregnant with their first children in 2014. Both women have doctorates and worked at Rand Corporation’s headquarters in Santa Monica, CA analyzing health care issues, NBC reports. Together, the women used their backgrounds in health care, and their friendship, to […]

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Aetna Settles Claim Denial Lawsuit
5 months Ago

Aetna Settles Claim Denial Lawsuit

Aetna has settled a lawsuit that included testimony in which one of the company’s medical directors admitted to not reviewing consumers’ medical records before denying their claims. An investigation by California’s insurance commissioner, which Consumers for Quality Care has previously written about, followed CNN reporting on the medical director’s comments. At the time of the […]

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PA Cancer Survivors Caught In Fight Between Health Care Giants
5 months Ago

PA Cancer Survivors Caught In Fight Between Health Care Giants

Consumers in Pennsylvania and beyond are bracing for potential impacts as two health care giants head towards a May court date, Kaiser Health News reports. The University of Pittsburgh Medical Center (UPMC) and Highmark Blue Cross Blue Shield are in the midst of a decade-long feud. Consumers fear it could result in a loss of […]

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Texas Teachers Face High Health Insurance Premiums, Hospital Bills
5 months Ago

Texas Teachers Face High Health Insurance Premiums, Hospital Bills

When Liz and Jeremiah Peña had their first child in 2000, their health insurance cost $100 per month. Two years later, when they welcomed another child, the premiums doubled. Liz and Jeremiah both work as teachers near Fort Worth and weren’t thrilled about the price increase, but said they could afford it. This past year, […]

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Minorities More Likely To Undergo Diabetes-Related Amputations
5 months Ago

Minorities More Likely To Undergo Diabetes-Related Amputations

Until 47-year-old Jackson Moss was first diagnosed with Type 2 diabetes, he says his health care was not a high priority and he often did not have health insurance. After his diagnosis, he got more diligent about his care, tried to eat better, and went to the doctor more often. A recent CNN analysis highlights […]

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Drug Distribution Company Chose Profits Over Human Life, U.S. Attorney Says
5 months Ago

Drug Distribution Company Chose Profits Over Human Life, U.S. Attorney Says

Executives from Rochester Drug Co-Operative, a drug distribution company, have been criminally charged in connection with the national opioid epidemic, NBC reports. The company’s former chief executive, Laurence Doud III, and former chief compliance officer, William Pietruszewski, were charged with conspiracy to violate narcotics laws and conspiracy to defraud the U.S. Pietruszewski was also charged […]

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Author Highlights Trends For PA Consumers
5 months Ago

Author Highlights Trends For PA Consumers

In a recent article, reporter Sarah Gantz highlighted the major trends she’s seen in the year since she began examining Philadelphia consumers’ medical bills for The Inquirer’s Philly Health Costs project. I’ve talked to insurers, hospitals, economists and analysts about the problems you’ve experienced; and written about what I found out. Everyone seems to have […]

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Set Of Stitches Highlights Procedure Price Variations
5 months Ago

Set Of Stitches Highlights Procedure Price Variations

When Christine Jaschinski’s husband, Wolfgang Faust, cut his thumb while working with drywall, she thought she was diligent in deciding where to take him. America’s ER was close to their home, accepted their insurance, and offered both urgent and emergency care services, Houston Chronicle reports. Jaschinski called ahead to get Faust into the urgent care […]

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Insurer Denies Coverage For 4-Year-Olds’ Cancer Treatment
5 months Ago

Insurer Denies Coverage For 4-Year-Olds’ Cancer Treatment

Photo by Heidi de Marco/KHN Krystal Hayden, the mother of 4-year-old Bentley, spent the recent holiday weekend worrying that this Easter may be his last, WKBW reports. “My heart’s just shattered and I kind of feel, you know, everything is darkening. It’s not really like a celebration. It’s like this may be my last Easter […]

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MA Patients Respond To Surprise Bills
5 months Ago

MA Patients Respond To Surprise Bills

Cheryle Reidel is no stranger to surprise bills. The first came after a 2012 cancer biopsy. The second, after an anesthesiologist and nurse billed her $2,600 for a procedure. The latest, totaling nearly $2,500, was the result of a colonoscopy. Reidel thought the procedure would be fully covered, but it turned out that the anesthesiologist […]

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Family Receives $3,700 Surprise Bill After Son’s Birth
5 months Ago

Family Receives $3,700 Surprise Bill After Son’s Birth

Laura and Adam Parkinson were happy about the birth of their son Nathan, last year. But just days after the birth the couple found themselves, like 57 percent of Americans, facing a surprise bill. CBS reports that the Parkinsons did their homework and selected an in-network hospital and obstetrician. They tried to avoid any surprise […]

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Consumers With High-Deductible Plans Delay Care
5 months Ago

Consumers With High-Deductible Plans Delay Care

In 2017, not long after giving birth to her first child, Susan found out that she carries a genetic mutation that increases her lifetime risk of breast cancer to 72 percent. Women who have the BRCA2 gene have a handful of treatment options. Some opt for a preventative double mastectomy. Susan wanted to continue to […]

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NY Woman With Cancer Appeals Insurance Denial
5 months Ago

NY Woman With Cancer Appeals Insurance Denial

When the pain in Diane Conine’s stomach was so unbearable that she was throwing up and her urine was filled with blood, her daughter drove her to the emergency room. She had already been to an urgent care center, where she was told she had a bladder infection, according to the Albany Herald. Conine spent […]

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Baby Born With Rare Skin Condition Denied Transfer to Specialized Facility
5 months Ago

Baby Born With Rare Skin Condition Denied Transfer to Specialized Facility

Priscilla Maldonado thought she was having a healthy baby boy after an uneventful pregnancy. But when she gave birth to her son, Ja’bari Gray, at Methodist Hospital in San Antonio on New Years Day, doctors quickly realized that something was wrong, according to News 4 San Antonio. Gray was born without skin from his neck […]

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PA Professor with Short-Term Health Plan Not Covered for Amputation
5 months Ago

PA Professor with Short-Term Health Plan Not Covered for Amputation

Stephanie Sena was in the hospital being treated for sepsis and preparing to have half her foot amputated when her doctor came to her room and told her that she needed to prepay nearly $2,000 for the surgery. Sena was no stranger to amputations. She had previously lost three toes to neuropathy in her foot, […]

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Cut Consumer Costs – In Their Own Words
5 months Ago

Cut Consumer Costs – In Their Own Words

American health care consumers are frequently frustrated by unexpected costs, a lack of clarity throughout the process of accessing care and other roadblocks when it comes to getting the health care they need. Many have taken to social media to discuss their experiences with things like high deductibles, unexpected emergency room bills and other challenges. […]

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PBM Denies Prescription After Calling Playtex Instead Of Doctor
5 months Ago

PBM Denies Prescription After Calling Playtex Instead Of Doctor

Robin Agar, a Delaware resident who runs a charity that benefits cancer patients, suffers from rheumatoid arthritis. Last year, her doctor prescribed the drug Xeljanz. The process for Agar to receive her medication, which Tarbell detailed, turned into a case study of the issues consumers can face when dealing with Pharmacy Benefit Managers (PBMs). Instead […]

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Survey Finds Nearly 6 in 10 Americans Delay Care
5 months Ago

Survey Finds Nearly 6 in 10 Americans Delay Care

As consumers grapple with high out of pocket costs, surprise bills, and skimpy coverage, a recent survey from Morning Consult and Business Insider examined how costs affect consumers’ behavior. Nearly 6 in 10 respondents reported that they have delayed or gone without medical or dental care due to cost. Thirty-one percent of respondents said they […]

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Local TV Station Helps Pay Off Tennesseans’ Medical Debt
5 months Ago

Local TV Station Helps Pay Off Tennesseans’ Medical Debt

In an effort to bring awareness to the medical debt affecting Americans, including thousands of Tennessee consumers, Nashville’s NewsChannel 5 donated $15,000 to an organization that used it to eliminate $1.8 million in medical debt for more than 600 Tennesseans. Consumers for Quality Care has previously highlighted the possible consequences of this kind of medical […]

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PBM Complications Cause Treatment Delay For Cancer Survivor
5 months Ago

PBM Complications Cause Treatment Delay For Cancer Survivor

When Lynn Lear completed her final round of chemotherapy for breast cancer last December, her doctor prescribed a drug called Nerlynx. Lear agreed to the medication, wanting to do everything she could to remain healthy after her battle with cancer. However, the prescription for the specialty drug could not be filled at her neighborhood pharmacy. […]

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CQC Research Illuminates Consumers’ Health Care Concerns
5 months Ago

CQC Research Illuminates Consumers’ Health Care Concerns

Photo by Heidi de Marco/KHN Consumers for Quality Care’s most recent survey findings shed light on consumers’ feelings toward America’s health care system. Benefits Pro highlighted the findings and noted that consumers are looking for greater predictability around health care costs and more quality coverage. The research found that consumers are more concerned with health […]

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Consumers Mourning Pregnancies Face Surprise Medical Bills
5 months Ago

Consumers Mourning Pregnancies Face Surprise Medical Bills

Four months before the due date, Lauren Dill lost her son, Simon Augustus. She suffered what is referred to as a “silent” miscarriage. Dill was induced and spent nine hours in labor. She told CBS News that she would never forget what her midwife said to her – “here is a perfect little baby without […]

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Student Athlete Denied Coverage
5 months Ago

Student Athlete Denied Coverage

Michael Okoye, an exchange student, was injured while playing basketball for his school, Cape Fear Christian Academy in North Carolina. Okoye was excelling in basketball and colleges were starting to take notice, CBS 17 reports. But that changed when Okoye was injured playing in a tournament at school. “The point guard from the other team, […]

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Overnight Stays Can Cause Confusion And Extra Cost For Consumers
5 months Ago

Overnight Stays Can Cause Confusion And Extra Cost For Consumers

Consumers are often blind-sided by the higher medical bills that can result from overnight hospital stays that are classified as “observations,” the Post-Gazette reports. Hospitals and insurance companies determine the classification, which denotes whether they believe patients require an inpatient hospital stay or outpatient monitoring. Small wonder it’s confusing: For the same care, the same […]

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Teen’s Emergency Results In $110K Bill
5 months Ago

Teen’s Emergency Results In $110K Bill

Jamie Hansen’s 15 year-old son, Ryan, was ten hours away at a Canadian summer camp when he texted complaining of hip pain and trouble breathing. At first, Jamie dismissed her son’s complaints, thinking it was just nerves. After a few days, his condition continued to worsen and Jamie drove up to get him, Stateline, an […]

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Man Pays Triple The Retail Price For Knee Brace
5 months Ago

Man Pays Triple The Retail Price For Knee Brace

Esteban Serrano was playing soccer with friends when he twisted his knee. As a prolific soccer player, Serrano had been injured before. He left the field to ice his knee and when it did not improve he decided it was time to visit the doctor, Kaiser Health News reports. Serrano made an appointment at Rothman […]

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Congressional Hearing Focuses On Surprise Bills
5 months Ago

Congressional Hearing Focuses On Surprise Bills

A recent hearing on surprise bills in the House Education & Labor Committee’s Health, Employment, Labor, and Pensions Subcommittee featured a resounding message: consumers should be protected from unexpected medical bills. The hearing comes at a time when surprise billing has been increasingly in the public spotlight. NPR, which reported on the hearing, has partnered […]

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Short-Term Health Plan Cancels Cancer Patient’s Policy
5 months Ago

Short-Term Health Plan Cancels Cancer Patient’s Policy

In 2016, Charley Butler was diagnosed with testicular cancer and he believed that his health insurance would help cover the cost of his care. Butler had previously been contacted by a broker for National Brokers of America Inc. and signed up for an 11-month insurance plan, Los Angeles Times reports. Butler said that the plan […]

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Some Consumers’ Anti-Rejection Drugs Not Covered By Insurance
5 months Ago

Some Consumers’ Anti-Rejection Drugs Not Covered By Insurance

Physicians who work with transplant recipients are highlighting a coverage gap that makes it harder for some to get the drugs they need to avoid organ rejection and stay alive, The New York Times reports. The drugs are vital for patients like 72-year-old Claudia McGinness, who underwent a double-lung transplant in 2008 after idiopathic pulmonary […]

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NC Family Fights For State Waiver And Treatment For Son
5 months Ago

NC Family Fights For State Waiver And Treatment For Son

24-year-old Landon Freeman has autism, bipolar disorder and obsessive-compulsive disorder. His parents took him to the Novant Health emergency room in the beginning of January after he attempted to run away from home. It was Landon’s fifth hospital visit since Thanksgiving, but it has become his longest, WFAE reports. Landon has remained in the emergency […]

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Americans Borrowed Nearly $90 Billion To Pay For Medical Expenses In 2018
5 months Ago

Americans Borrowed Nearly $90 Billion To Pay For Medical Expenses In 2018

A recent survey from Gallup and West Health estimates that Americans borrowed $88 billion to pay for health care-related expenses in 2018, The New York Times reported. The survey’s authors said that while the data was complex, one conclusion was clear: “High health care costs had created significant anxiety.” The survey adds to recent research […]

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Cut Consumer Costs – In Their Own Words
6 months Ago

Cut Consumer Costs – In Their Own Words

American health care consumers are frequently frustrated by unexpected costs, a lack of clarity throughout the process of accessing care and other roadblocks when it comes to getting the health care they need. Many have taken to social media to discuss their experiences with things like high deductibles, unexpected emergency room bills and other challenges. […]

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NY Woman’s Surprise Bill Inspires State Legislation
6 months Ago

NY Woman’s Surprise Bill Inspires State Legislation

Claudia Knafo tried to comparison shop. When she knew she needed spinal surgery in 2012, she consulted multiple surgeons. Ultimately, she selected one whose website indicated her insurance was accepted, Vox reports. At an appointment, the surgeon’s office photocopied her insurance card. Thankfully, Knafo’s surgery went well and she recovered easily. All seemed to have […]

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Medical Debt Contributes To More Than Half Of Personal Bankruptcy Filings
6 months Ago

Medical Debt Contributes To More Than Half Of Personal Bankruptcy Filings

Americans are paying the price for getting sick or hurt, according to new research. A recent survey, published in the American Journal of Public Health, found that nearly 60 percent of people who have filed for personal bankruptcy reported that a medical expense “very much” or “somewhat” contributed to their financial situation, according to The […]

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Missouri Man Recovering From Car Accident Fights For Coverage
6 months Ago

Missouri Man Recovering From Car Accident Fights For Coverage

James Henderson, a 74-year-old Missouri man who was critically injured and lost his wife in a 47-car pileup, is now battling his insurance company. Henderson has been in the intensive care unit at CenterPoint Medical Center since the mid-February crash, Stamford Advocate reports. Henderson’s family says that five of his doctors have suggested he be […]

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Loophole In MS Law Means Consumers Still Get Surprise Bills
6 months Ago

Loophole In MS Law Means Consumers Still Get Surprise Bills

With medical debt the leading cause of bankruptcy in the country, a new video report from CBS News highlights how a loophole leaves consumers with surprise medical bills that they shouldn’t receive. Close to 65 percent of emergency departments around the country are staffed by outside companies, according to CBS News. For consumers, this arrangement […]

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WA Woman Faces $227K In Medical Bills
6 months Ago

WA Woman Faces $227K In Medical Bills

Debbie Moehnke was already in a Vancouver, Wash., medical clinic when she had a massive heart attack. She had made the appointment because her feet were extremely swollen, her husband Larry tells Time. As she waited, she began to feel like she couldn’t breathe. Moehnke was rushed, by ambulance, from the clinic to a local […]

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As Judge Strikes Down AR, KY Work Requirements, Consumers In Other States Brace For Their Own
6 months Ago

As Judge Strikes Down AR, KY Work Requirements, Consumers In Other States Brace For Their Own

Photo by Heidi de Marco/KHN In New Hampshire, some residents are anxiously preparing for the state’s Medicaid work requirements to take effect this June. The change, which will impact 50,000 residents, requires that New Hampshirites work at least 100 hours to qualify for Medicaid or risk losing coverage as soon as August. The change could […]

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AMA: Prior Authorization Process Is Dangerous
6 months Ago

AMA: Prior Authorization Process Is Dangerous

In an op-ed published in the Baltimore Sun, Dr. Barbara McAneny, president of the American Medical Association, outlines the dangers of insurance prior authorizations. Prior authorizations can delay consumers’ care. Those delays can mean added pain and frustration for patients already facing difficult diseases. For some, like Colin Haller, it can feel like an avoidable […]

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Surprise Medical Bills Result In Home Liens, Crippling Debt
6 months Ago

Surprise Medical Bills Result In Home Liens, Crippling Debt

After Nicole Briggs woke up one night with intense stomach pain and drove herself to a freestanding ER, she was told that she had appendicitis and needed surgery. As she rushed to nearby Swedish Medical Center, she called to make sure that the hospital would be in her insurance network, NBC reports. Even when the […]

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Insurance Companies, Hospitals Resist Transparency Proposal
6 months Ago

Insurance Companies, Hospitals Resist Transparency Proposal

Insurance companies and hospitals are fighting against a recent proposal to increase transparency for consumers, according to The Wall Street Journal. The proposed rule, which Consumers for Quality Care has previously reported on, would make the negotiated payment rates between insurers and providers public. The idea of increasing transparency has been lauded by consumer advocates […]

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Critics Warn Consumers Against Short-Term Plans In Arizona
6 months Ago

Critics Warn Consumers Against Short-Term Plans In Arizona

Critics in Arizona, including Democratic lawmakers and physicians, are warning consumers about the risks associated with short-term limited-duration insurance plans (STLDI), reports The Arizona Mirror. They warn that the plans often contain coverage gaps that can result in hefty bills for consumers. “It’s ‘buyer beware,’” Dr. Paul Kozak, an emergency room physician said to the […]

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WA Couple Faces Surprise Medical Bill
6 months Ago

WA Couple Faces Surprise Medical Bill

When David Sprecher’s wife, Tyna, was having issues breathing following pneumonia treatment, he brought her to a local emergency room. He believed did everything right, choosing an in-network hospital, Deaconness, according to The Spokesman-Review. Sprecher says that at every turn of Tyna’s care they asked the physicians and nurses if insurance would cover the expenses. […]

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More States Around The Country Address Surprise Billing
6 months Ago

More States Around The Country Address Surprise Billing

As surprise medical bills cause headaches for consumers around the country, some states have ramped up efforts to protect consumers. Consumers for Quality Care has reported on changes lawmakers are pursuing in Arizona, California, and other states to address the practice of balance and surprise billing. Now, lawmakers in Washington and Nevada are addressing the […]

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CA Families Struggle To Receive Mental Health Care
6 months Ago

CA Families Struggle To Receive Mental Health Care

In February 2018, Jill Williams brought her 25-year old son, Austin, to the Sutter Roseville emergency room. Austin, who has schizophrenia, was agitated, not speaking, and unable to walk. Around 11 p.m., Williams left the hospital to get some sleep. She asked the hospital to inform her when Austin was going to be discharged so […]

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Alaskans Fight Loopholes That Deny Coverage To Kids
6 months Ago

Alaskans Fight Loopholes That Deny Coverage To Kids

Brian Brubaker’s daughter, Emily, faces years of expensive dental work. She was born with a rare condition called ectodermal dysplasia, which affects hair, skin, and teeth. Because of the condition, Emily has no adult teeth and will have to have them surgically replaced. Children born with ectodermal dysplasia are among the four percent of individuals […]

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New Analysis Investigates Complications In Childbirths
6 months Ago

New Analysis Investigates Complications In Childbirths

Hospitals often blame maternity deaths on factors beyond their control but data suggests they may be at fault, according to a recent analysis from USA Today. The analysis examined billing data from nearly 7 million births across 13 states and found complications at more than 1,000 hospitals. Roughly one in eight hospitals have complication rates […]

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Alternative Plans Could Leave Consumers Paying More
6 months Ago

Alternative Plans Could Leave Consumers Paying More

As consumers seek lower-cost alternatives to ACA plans, many have turned to alternatives like short-term limited duration policies or Christian-sharing ministries. These plans carry risks and could leave consumers paying more, not less, according to NPR and Kaiser Health News. These risky plans are presented as alternatives for consumers who cannot afford the premiums of […]

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WA Legislature Addresses Balance Bills
6 months Ago

WA Legislature Addresses Balance Bills

Washington’s state legislature is considering a proposal to help alleviate the burden of balance billing, Public News Service reports. Balance billing, a kind of surprise medical billing, occurs when patients receive care from an out-of-network provider at an in-network facility. Consumers often end up with balance bills after an emergency situation. Dr. Nathan Schlicher, a […]

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New Proposed Rule Aims to Increase Transparency of Provider and Insurer Payment Negotiations
6 months Ago

New Proposed Rule Aims to Increase Transparency of Provider and Insurer Payment Negotiations

Consumers may finally get some insight into negotiated payment rates but even greater transparency could still be necessary. The federal government is considering a new rule to publish the negotiated payment rates between providers and insurance companies. According to The Wall Street Journal, the change would expose the true cost of care for consumers. If […]

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Judge Rules UnitedHealth Discriminated On Mental Health Treatment
6 months Ago

Judge Rules UnitedHealth Discriminated On Mental Health Treatment

A Northern California federal judge has issued a “scathing ruling” that a subsidiary of insurance giant UnitedHealth Group implemented internal policies that discriminated against patients with mental health and substance abuse issues, according to The New York Times. In his decision, U.S. Chief Magistrate Judge Joseph C. Spero said that United Behavioral Health, a unit […]

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State, Federal Officials Work To Curb Surprise Billing
6 months Ago

State, Federal Officials Work To Curb Surprise Billing

Consumers often face surprise medical bills after receiving care from an out-of-network provider at an in-network facility. Even when consumers are vigilant, they can end up with surprise bills. This was true for Khrystyna Greene, who went to a free-standing emergency room in San Antonio to get care for her son who had fallen and […]

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PBM Delays Put Patients At Risk, Oncologists Warn
6 months Ago

PBM Delays Put Patients At Risk, Oncologists Warn

Cancer patients are facing delays in receiving care and access to critical oncology drugs as a result of pharmaceutical benefit managers (PBMs) practices. These delays, oncologists warn, are putting their lives at risk, Medscape reports. “[A] patient had metastatic kidney cancer, and his oncologist was seeking to treat him with sunitinib malate (Sutent, Pfizer), a […]

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Consumers Put In Middle Of Fight Between Insurers, Providers
6 months Ago

Consumers Put In Middle Of Fight Between Insurers, Providers

Consumers find themselves in the middle of a fight between insurers and providers, according to a new lawsuit. According to CNN, the suit alleges that Anthem is paying consumers directly, in an effort to pressure providers to join its network. The insurer sent more than $1.3 million in money owed to out-of-network providers to consumers. […]

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South Florida Woman Gets Surprise Bill For “Free” Allergy Testing
6 months Ago

South Florida Woman Gets Surprise Bill For “Free” Allergy Testing

In 2016, Elizabeth Perez went to hotel in Broward County, Florida for a free allergy test she had seen advertised online. The advertisement was from Primera Medical Group, based in Atlanta, Georgia. Perez said the techs drew blood and performed a skin allergy test. She expected to get her results in the mail, according to […]

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Consumers Rarely Appeal Denied Claims
6 months Ago

Consumers Rarely Appeal Denied Claims

Consumers are not appealing insurance denials and when they do, the denials are often being upheld. A recent study from the Kaiser Family Foundation found that consumers enrolled in ACA health care plans usually do not appeal their denials, Becker’s Hospital Review reports. The study analyzed 230 million claims submitted to 130 insurers in 2017 […]

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Kentucky Warns Consumers About Short-Term Health Plans
6 months Ago

Kentucky Warns Consumers About Short-Term Health Plans

Photo by Heidi de Marco/KHN Consumers are being warned that short-term limited-duration insurance plans may not provide them the coverage they need. The Kentucky Department of Insurance’s website has published an alert warning consumers about short-term limited-duration health plans, Insider Louisville reports. The alert includes a question and answer section that provides information about the […]

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Breast Cancer Survivor Fights For Coverage
6 months Ago

Breast Cancer Survivor Fights For Coverage

Photo by Heidi de Marco/KHN A breast cancer survivor is fighting for coverage for herself and thousands of other women after her insurance company denied a routine follow-up test, ABC7 reports. Alice Anselmo is lucky to be cancer free. She was shocked, however, when her insurer, Aetna, said it would not cover her breast MRI. […]

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Yearlong Investigation Leads To Action Against PBM In Ohio
7 months Ago

Yearlong Investigation Leads To Action Against PBM In Ohio

Ohio Attorney General David Yost announced that the state would seek a $16 million repayment from OptumRx, a pharmacy benefit manager (PBM) owned by UnitedHealth. OptumRx, which served as the middleman for Ohio’s Bureau of Workers’ Compensation, allegedly overcharged the bureau since 2015, the Columbus Dispatch reports. Yost’s decision to seek repayments from OptumRx comes […]

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PA Woman Faces $16K Bill After Fainting
7 months Ago

PA Woman Faces $16K Bill After Fainting

A Pennsylvania woman received a medical bill of more than $16,000 after her short-term limited-duration insurance plan failed to cover her fully, Lancaster Online reports. Pennsylvania Insurance Commissioner Jessica Altman highlighted the consumer’s story at a recent U.S. House subcommittee hearing. The woman who fainted hit her head, Altman said, and the plan paid $200 […]

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Cancer Treatment’s Surprise Side Effect: Billing Issues
7 months Ago

Cancer Treatment’s Surprise Side Effect: Billing Issues

Since Carol Marley was diagnosed with cancer, her most “gnawing, ever present concern” has been something she never anticipated. It’s not chemo or fear of the unknown, according to NPR. Instead, it’s the bills. She wasn’t prepared for the confusing medical bills and hours on the phone with her insurance and providers. “I have faith […]

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Texas Seeks To Clarify Provider Confusion
7 months Ago

Texas Seeks To Clarify Provider Confusion

According to recent CQC research, more than 60 percent of survey respondents say it’s too difficult to know how much they are going to have to pay for health care. Texas lawmakers have introduced legislation that seeks to alleviate some of that confusion by clarifying freestanding emergency room billing practices, KXAN reports. House Bill 2041, […]

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Woman Lands Behind Bars After Unpaid Medical Bill
7 months Ago

Woman Lands Behind Bars After Unpaid Medical Bill

When Melissa Welch-Latronica was pulled over by police, she handed over her driver’s license and waited. She did not feel anxious until she saw a second squad car pull up behind the car that had pulled her over, she told Chicago Tribune. She had a clean record and was confused as to what was taking […]

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New AZ Law Addresses Balance Billing
7 months Ago

New AZ Law Addresses Balance Billing

A new law in Arizona addresses balance billing, a practice that leaves consumers with surprise medical bills, AZ Family reports. SB 1441 aims at reducing the burden that surprise bills put on patients. After a consumer receives a balance bill, the consumer, their insurer and the provider are required to have a conference call with […]

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Spotlight On Consumer Stories Inspires Policy Changes In CA
7 months Ago

Spotlight On Consumer Stories Inspires Policy Changes In CA

After numerous reports highlighting balance billing issues at Zuckerberg San Francisco General Hospital, state officials are taking action to better protect consumers. State representatives have introduced legislation to end the practice of balance billing, which leaves consumers with costly bills like the woman who received a $20,000 bill after a minor bike crash. The new […]

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Wait Time For Hospital Beds Hurts Consumers
7 months Ago

Wait Time For Hospital Beds Hurts Consumers

Emergency patients might have a harder time getting admitted to the hospital than they anticipate. A new study examined over a million Medicare cases and found that hospitals often make $700 more on elective admissions than on emergency department cases, according to the Washington Post. This financial incentive means that elective patients often take priority […]

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Study Finds Coloradans Skip Care Out Of Fear Of Costs
7 months Ago

Study Finds Coloradans Skip Care Out Of Fear Of Costs

A new study found that some Colorado residents have skipped care due to fear of the costs, 9news reports. The study by the Colorado Consumer Health Initiative examined the frequency and impact of health care costs on the state’s residents. It found that 34 percent of privately insured Coloradans received a surprise medical bill in […]

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PA Couple Fights Surprise Bill
7 months Ago

PA Couple Fights Surprise Bill

A Pennsylvania couple has paid a medical bill “in protest” after spending seven months trying to get the bill corrected, The Inquirer reports. Dave Southard got his first colonoscopy at age 64. Colonoscopies are supposed to be fully covered for consumers between 50 and 75 years old who have private insurance. After Southard received a […]

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Cat Bite Leads To $49K Bill
7 months Ago

Cat Bite Leads To $49K Bill

When Jeannette Parker saw a skinny and sick-looking stray kitten outside of Florida’s Everglades National Park, she decided to feed it some tuna she had in her car. The kitten bit her finger and broke the skin. Parker cleaned the wound, but she began to worry about rabies due to warnings in the area, NPR […]

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States, Stakeholders Fight Surprise Bills
7 months Ago

States, Stakeholders Fight Surprise Bills

As consumers face rising premiums, high deductibles, and surprise bills, state lawmakers and national stakeholders are fighting to control health care costs for consumers. The Center for American Progress reports that only six states currently have comprehensive protections against surprise bills. In Georgia, legislators are working on a bill to address surprise medical bills, according […]

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Brokers’ Commissions From Insurers Impact How Much Consumers Pay
7 months Ago

Brokers’ Commissions From Insurers Impact How Much Consumers Pay

As the average cost of employer sponsored health care plans has tripled over the last two decades, ProPublica and NPR are examining the impact insurance brokers have had on these prices. The system of payments to brokers incentivizes them to push employers toward more costly plans. Employers often turn to health insurance brokers to help […]

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Consumers Run Into Road Blocks With Anthem Policy
7 months Ago

Consumers Run Into Road Blocks With Anthem Policy

Anthem’s controversial emergency department policy added confusion to the nation’s already confusing health care system. The policy, which CQC has previously reported on, allowed Anthem to retroactively deny coverage for consumers’ ER visits if the insurer determines the situation was not actually an emergency. While Anthem said the policy was designed to reduce unnecessary ER […]

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Consumers Beware: Company Tricked Consumers Into Thinking They Were Covered
7 months Ago

Consumers Beware: Company Tricked Consumers Into Thinking They Were Covered

Florida-based Simple Health Plans and its CEO Steve Dorfman are at the center of an FTC suit that alleges they tricked consumers into thinking they were buying comprehensive health coverage, CBS reports. Consumers believed their policies provided ample coverage. Instead, they received huge medical bills. One victim, Julia Wilber, went to the emergency room after […]

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Inaccurate Provider Directories Hurt Consumers
7 months Ago

Inaccurate Provider Directories Hurt Consumers

Consumers trying to avoid seeking treatment from out-of-network providers to prevent surprise bills often turn to their health plan’s provider directories. But a recent article from Fierce Healthcare highlights issues with ensuring provider directories are accurate – and how it hurts consumers when they are not. Provider directories – or the list of in-network physicians– […]

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Insurer Denies Surgery To Fix Complication From Gunshot Injury
7 months Ago

Insurer Denies Surgery To Fix Complication From Gunshot Injury

Recently divorced and facing financial trouble, Joseph Pero was in a self-described “dark place” in 2017. Then, he did the unthinkable and pointed a handgun at his own heart. Thankfully, he missed. Instead, the bullet hit his lungs and fractured six ribs. In that moment, Pero realized that he wanted to live. The Los Angeles […]

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President Of The American College Of Emergency Physicians Speaks Out Against Controversial ER Policy
7 months Ago

President Of The American College Of Emergency Physicians Speaks Out Against Controversial ER Policy

In a recent op-ed published in Newsweek, Vidor Friedman, President of the American College of Emergency Physicians, pushed back against a controversial ER policy, which he calls “disturbing.” The policy, which CQC has previously reported on, retroactively denies emergency room coverage if the insurer believes that the patient should have sought a lower degree of […]

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Cut Consumer Costs – In Their Own Words
7 months Ago

Cut Consumer Costs – In Their Own Words

American health care consumers are frequently frustrated by unexpected costs, a lack of clarity throughout the process of accessing care and other roadblocks when it comes to getting the health care they need. Many have taken to social media to discuss their experiences with things like high deductibles, unexpected emergency room bills and other challenges. […]

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New Hampshire Woman Who Received Surprise Bill Attended State Of The Union
7 months Ago

New Hampshire Woman Who Received Surprise Bill Attended State Of The Union

New Hampshire resident Donna Backman was selected to be Sen. Maggie Hassan’s (D-NH) guest for the State of the Union address earlier this month. Sen. Hassan invited Backman to help bring awareness to the issue of surprise billing, The Eagle-Tribune reports. “I asked her if she wanted to come down and be my guest because […]

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Studies Show Health System Consolidation Leads To Worse Health Care
7 months Ago

Studies Show Health System Consolidation Leads To Worse Health Care

A recent New York Times article highlights the negative consequences of large-scale health care mergers, such as hospital mergers. The increasing occurrences of mergers and consolidation have previously been scrutinized for increasing consumer costs. But now evidence suggests that hospital mergers lead to worse health outcomes as well. Markets for both hospitals and physicians have […]

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Medical Billing Legislation Brings Hope, Disappointment For Consumers In CO & MS
7 months Ago

Medical Billing Legislation Brings Hope, Disappointment For Consumers In CO & MS

The Colorado State Legislature recently introduced legislation to protect consumers from surprise medical bills, FOX reports. Surprise billing, a practice where consumers are charged for receiving care from out-of-network practitioners at in-network facilities, is increasingly common for consumers. Recent CQC research found that 74 percent of consumers are frustrated by unexpected hospital bills and fees. […]

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Consumers’ Stories Highlight Cost Discrepancies At SC Hospitals
7 months Ago

Consumers’ Stories Highlight Cost Discrepancies At SC Hospitals

When Luke Drager wiped out while skim-boarding in Hilton Head, his parents took him to Hilton Head Hospital’s emergency room because they feared he had broken his ankle. At the hospital, the family was given a cost estimate of about $770 for Luke’s X-rays. Months later, the Dragers were shocked when they received a hospital […]

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New Report Shows Financial Burden Passed On To Privately Insured Coloradans
7 months Ago

New Report Shows Financial Burden Passed On To Privately Insured Coloradans

Over a 9-year period, Colorado consumers could have saved $11.5 billion if hospitals contained costs and profit margins, The Associated Press reports. According to a new state report, hospitals charged patients with private insurance more, even as revenues increased. In 2009, Medicare and Medicaid in Colorado paid 78 cents and 54 cents, respectively, for every […]

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GA Lawsuit Says Anthem Duped Consumers
7 months Ago

GA Lawsuit Says Anthem Duped Consumers

Consumers in Georgia believe they were misled by Anthem, according to local NBC station 11Alive. John Marks, a retiree who has survived both cancer and a heart attack, is careful each year when he chooses his insurance plan. He knows how vital his medical care is and would never want to jeopardize it. He has […]

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States Unable To Properly Regulate Or Warn Consumers About Risky Short-Term Insurance Plans
7 months Ago

States Unable To Properly Regulate Or Warn Consumers About Risky Short-Term Insurance Plans

State regulators do not have the authority or capacity to regulate the marketing of potentially risky short-term insurance plans, according to Modern Healthcare. The article cites a new study from the Georgetown Center on Health Insurance Reforms, which examines states’ ability to regulate the marketing of these plans after a HHS regulation expanded the plans’ […]

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Man Denied ER Coverage As A Result Of Controversial Anthem Policy
7 months Ago

Man Denied ER Coverage As A Result Of Controversial Anthem Policy

When Paul Sweatman’s left ankle swelled to three times its normal size in 2017, his first stop was an urgent care clinic. The urgent care said that the case was more complex than they were able to handle and sent him to Atlanta Medical Center. The hospital’s staff discussed the possibility of amputation. Fortunately, they […]

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New Study Highlights Impact Of Hospital Prices
7 months Ago

New Study Highlights Impact Of Hospital Prices

A new study from Health Affairs highlights the impact that hospital prices have on the nation’s health care spending, Modern Healthcare reports. The study found that increasing hospital prices are the largest driver of national health care spending inflation. The prices increased 42 percent over a seven-year period, from 2007 to 2014. In comparison, physician […]

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Consumers Cost Concerns – In Their Own Words
8 months Ago

Consumers Cost Concerns – In Their Own Words

American health care consumers are frequently frustrated by unexpected costs, a lack of clarity throughout the process of accessing care and other roadblocks when it comes to getting the health care they need. Many have taken to social media to discuss their experiences with things like high deductibles, unexpected emergency room bills and other challenges. […]

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As Insurers And Providers Quarrel, Consumers Lose Out
8 months Ago

As Insurers And Providers Quarrel, Consumers Lose Out

When David Lerman’s insurance changed to Anthem Blue Cross of California this year, he did not realize that the insurer was in a dispute with the largest medical provider in the community, Sutter Health. The insurer and provider, which operates 24 hospitals and roughly 5,000 physicians in Northern California, are battling over the cost of […]

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Examination Of List Prices Highlights Hospital Price Fluctuations
8 months Ago

Examination Of List Prices Highlights Hospital Price Fluctuations

The new federal rule that requires hospitals to post list prices online was meant to help consumers comparison shop. Now, a California Healthline investigation examines how this new policy is bringing to light huge hospital price fluctuations. California Healthline looked at the chargemasters, which enumerate a hospital’s list prices, of four large hospitals in the […]

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Twins In Need Highlight When Consumers Turn To The Internet For Help
8 months Ago

Twins In Need Highlight When Consumers Turn To The Internet For Help

Feeling burdened by high medical costs, more and more consumers are turning to crowdsourcing on the Internet. Over the summer, Consumer for Quality Care reported on this trend, which shows a third of all GoFundMe donations now made are to defray medical costs. GoFundMe’s CEO Rob Solomon recently spoke to CBS News about the phenomenon. […]

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North Carolina Man Receives $4,700 Bill After Fainting
8 months Ago

North Carolina Man Receives $4,700 Bill After Fainting

Matt Gleason got a flu shot when his employer offered them for free in the office, but he fainted five minutes after receiving his shot. Gleason has a history of fainting and came to quickly, but his coworker had already called 911, Kaiser Health News reports. After five minutes, he began vomiting and agreed to […]

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Utah Man Faces $106K Balance Bill
8 months Ago

Utah Man Faces $106K Balance Bill

When Sterling Slade got in a motorcycle accident last April, he was taken by ambulance to Intermountain Medical Center. Unconscious and fighting a catastrophic brain injury, Slade had no say in which hospital he was taken to, KUTV reports. Thanks to the medical staff at Intermountain Medical Center, he is alive today. A few months […]

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As Consumers Suffer, Some Texas Hospitals Rake In Big Bucks
8 months Ago

As Consumers Suffer, Some Texas Hospitals Rake In Big Bucks

While consumers increasingly are facing expensive balance billing and surprise bills and many rural hospitals are closing, some Texas hospitals are bringing in huge profits, The Dallas Morning News reports. All D-FW hospitals combined had an average profit margin of 12.7 percent. That surpassed margins in many other regions, including Minneapolis (4.3 percent), Detroit (5.5 […]

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Consumer Cost Concerns – In Their Own Words
8 months Ago

Consumer Cost Concerns – In Their Own Words

American health care consumers are frequently frustrated by unexpected costs, a lack of clarity throughout the process of accessing care and other roadblocks when it comes to getting the health care they need. Many have taken to social media to discuss their experiences with things like high deductibles, unexpected emergency room bills and other challenges. […]

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Hospitals Posting List Prices Bring Little More Transparency
9 months Ago

Hospitals Posting List Prices Bring Little More Transparency

Photo by Heidi de Marco/KHN As of January 1, hospitals are required to post list prices online, although it is not immediately clear how helpful the new postings will be for consumers. Kaiser Health News reports that while hospitals are posting the information, it is still far from clear how much consumers will actually need […]

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Short-Term Plans Offer Mixed Results For Consumers And Bigger Profits For Brokers And Insurers
9 months Ago

Short-Term Plans Offer Mixed Results For Consumers And Bigger Profits For Brokers And Insurers

Short-term health insurance plans have become increasingly popular as a result of rising premiums and recent actions by the Trump Administration. As Kaiser Health News reports: Driven by rising premiums for Affordable Care Act plans, interest in short-term insurance is growing, boosted by Trump administration actions to ease Obama-era restrictions and possibly make federal subsidies […]

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Couple Takes On 5 Jobs To Pay Medical Bills
9 months Ago

Couple Takes On 5 Jobs To Pay Medical Bills

One Virginia couple is doing all they can to keep up with their medical bills, which includes taking on five jobs between the two of them. Unfortunately, Tiffany Cano says it is still not enough. Tiffany and her husband, Robert, have racked up more than $12,000 in medical debt since their son, Brody, was born […]

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New Mexico Doing More To Help Consumers Facing Surprise Bills
9 months Ago

New Mexico Doing More To Help Consumers Facing Surprise Bills

New Mexico’s Office of Superintendent of Insurance (OSI) is making changes to help consumers who are facing surprise bills, KRQE writes. The office reports that it has added new management and is considering introducing legislation to streamline resolutions for consumers facing surprise bills. New Mexico’s Superintendent of Insurance, John Franchini, says he knows that surprise […]

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What Can You Learn From A Year’s Worth Of ER Bills?
9 months Ago

What Can You Learn From A Year’s Worth Of ER Bills?

In October 2017, Vox’s Sarah Kliff began her emergency room bill project. Over the subsequent 15 months, she has received and reviewed 1,182 consumer emergency room bills from all 50 states and D.C., she reports. The goal was to gain a better understanding of the unpredictability and costliness of ER bills, specifically looking at the […]

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Vermont Woman’s Broken Leg Results In $100,000 Bill
9 months Ago

Vermont Woman’s Broken Leg Results In $100,000 Bill

When Sarah Witter fell skiing and could not get back up, she knew that she had suffered a serious fall. What she did not know – or even anticipate – was the aftermath that the fall would create, Kaiser Health News reports. At the hospital, x-rays showed that Witter had broken two major bones in […]

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Insurer Denies New Wheelchair For Chicago Child
9 months Ago

Insurer Denies New Wheelchair For Chicago Child

Keisheya Spencer says she never expected to have to fight her insurance company to cover a wheelchair for her son with Cerebral palsy, Keyshawn Griffin. Spencer says that her insurer, Blue Cross Blue Shield, used to cover most of what Keyshawn needed. Then a few months ago, it began to push back, CBS reports. Since […]

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Price Depends On Who Is Paying
9 months Ago

Price Depends On Who Is Paying

A new story from Kaiser Health News highlights how a health provider’s price for medical implants is heavily dependent on who is paying. When Kim Daniels had reconstructive surgery following the double mastectomy she had after undergoing cancer treatment, the implants she selected cost her insurance, PennCare, $7,000. Such a high charge for the exact […]

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Insurers Increasingly Offer Narrow Network Plans
9 months Ago

Insurers Increasingly Offer Narrow Network Plans

In 2019, it will be more important than ever for consumers to educate themselves about their insurance plans and specifically their network of providers. While the news that more health insurance plans are available for 2019 suggests that consumer choice is on the rise, a new report from Avalere suggests that may not be the […]

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Consumer Cost Concerns – In Their Own Words
10 months Ago

Consumer Cost Concerns – In Their Own Words

American health care consumers are frequently frustrated by unexpected costs, a lack of transparency and other roadblocks when it comes to accessing the health care they need. Many have taken to social media to discuss their experiences with things like high deductibles, unexpected emergency room bills and other challenges. Here, we highlight posts from individuals […]

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Mother Receives Huge Bill For Her MS Treatments
10 months Ago

Mother Receives Huge Bill For Her MS Treatments

Shereese Hickson has a 9-year-old son and an income of just $770 per month. She was also diagnosed with multiple sclerosis in 2012. With her limited income, the bill she received for a new MS treatment left her shocked and worried; her share would cost over $3,000, NPR reports. Total bill: $123,019 for two Ocrevus […]

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Beware Of Big Surprise Bills From Medical Labs
10 months Ago

Beware Of Big Surprise Bills From Medical Labs

In addition to surprise medical bills they may incur from emergency departments, hospitals, and doctors, consumers need to be aware of surprise bills from medical labs. An Iowa woman who needed a biopsy thoroughly prepared and thought she had everything preapproved for her procedure. She still received a surprise medical bill for hundreds of dollars […]

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Consumer Cost Concerns: Consumers Contact CQC
10 months Ago

Consumer Cost Concerns: Consumers Contact CQC

American health care consumers are frequently frustrated by unexpected costs, a lack of transparency and other roadblocks to accessing the health care they need. Many have taken to social media to discuss their experiences with things like high deductibles, unexpected emergency room bills and other challenges. Here, we highlight posts from individuals sharing their stories […]

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New York Times Investigation Shows Hospital Consolidation Increases Prices for Consumers
10 months Ago

New York Times Investigation Shows Hospital Consolidation Increases Prices for Consumers

Over the past decade, hospital systems have merged at rapid rates, creating large scale organizations that impact consumers’ care on virtually all levels. As the mergers continued, expanding to include physicians’ and doctors’ groups, hospitals have said that coordinated services and savings would trickle down to consumers and result in cheaper prices. But an analysis […]

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Jury Awards Family $25.5 Million After Aetna Denies Coverage
10 months Ago

Jury Awards Family $25.5 Million After Aetna Denies Coverage

The family of an Oklahoma woman who was denied cancer coverage by Aetna has been awarded $25.5 million, in what is believed to be the largest individual verdict for a “bad faith” insurance case in the state’s history. CNN reports that the jurors warned that Aetna should heed their verdict as a message for the […]

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Consumer Cost Concerns – In Their Own Words
11 months Ago

Consumer Cost Concerns – In Their Own Words

American health care consumers are frequently frustrated by unexpected costs, a lack of transparency, and other roadblocks when it comes to accessing the health care they need. Many have taken to social media to discuss their experiences with things like high deductibles, unexpected emergency room bills and other challenges. Here, we highlight posts from individuals […]

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New Blue Cross Plan Has Consumers Pay, Wait For Reimbursement
11 months Ago

New Blue Cross Plan Has Consumers Pay, Wait For Reimbursement

A new Blue Cross Blue Shield plan being offered on North Carolina’s exchange for 2019 will save consumers between 30 and 33 percent on their monthly premiums, but it comes with an important and costly caveat: it has no provider network, meaning all doctors and hospitals will be treated as out-of-network and can charge consumers […]

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Woman’s Allergy Test Cost Nearly $50,000
11 months Ago

Woman’s Allergy Test Cost Nearly $50,000

Janet Winston has always had sensitive skin. For years, she avoided lipstick and cosmetics. After an antifungal cream prescribed to treat a rash only made it worse, she decided it was time to see a specialist, Kaiser Health News reports. Knowing her local dermatologist would be booked for months, Winston drove six hours to Stanford […]

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Local News Station Highlights PBMs’ Effects On Consumers
11 months Ago

Local News Station Highlights PBMs’ Effects On Consumers

Wilmington’s WECT News recently highlighted a local pharmacist who is helping patients fight against drug price inflation. Gerald Michael, who runs a family owned pharmacy, recounts the discrepancies between what he pays for prescription medications and what the pharmacy benefit manager (PBM) is telling him to charge patients. In one instance, a prescription that cost […]

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Mother’s Story, Government Data Show Power In Appealing Denials
11 months Ago

Mother’s Story, Government Data Show Power In Appealing Denials

When Diane Parnell’s youngest son, Brandon, woke up in the middle of the night complaining of severe abdomen pain for a third day in a row, she decided it was time to take him to the emergency room. Brandon’s older brother, Jamie, had spent 3 days in the hospital fighting sepsis, after his appendix had […]

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Controversial ER Policy Could Result In Denials For As Many As 16% Of Visits
11 months Ago

Controversial ER Policy Could Result In Denials For As Many As 16% Of Visits

A new analysis shows that the controversial Anthem emergency department policy could result in the denial of claims for as many as 16 percent of visits if expanded nationally, Reuters reports. The study, which was reported in JAMA Network Open, found that consumers could be denied even when their symptoms are identical to symptoms of […]

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Consumer Cost Concerns – In Their Own Words
11 months Ago

Consumer Cost Concerns – In Their Own Words

American health care consumers are frequently frustrated by unexpected costs, a lack of transparency, and other roadblocks when it comes to accessing the health care they need. Many have taken to social media to discuss their experiences with things like high deductibles, unexpected emergency room bills and other challenges. In our new series, “Consumer Cost […]

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Texas Fines Humana Over Narrow Network
11 months Ago

Texas Fines Humana Over Narrow Network

The state of Texas has fined insurer Humana $700,000 for “network adequacy deficiencies,” FierceHealthcare reports. The fine comes amid increasing attention on consumers who have received surprise medical bills and could signal the intent of state regulators to take more direct action against surprise bills. Surprise bills often occur when insurance companies have contracts with […]

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Connecticut Consumers Speak Out Over Health Care Costs
11 months Ago

Connecticut Consumers Speak Out Over Health Care Costs

Photo by Heidi de Marco/KHN Lara Herscovitch says that her transition to working as a freelance musician has been “joyful,” but there have been some challenges. Since the former Connecticut state troubadour left her full time job, Hersovitch’s health care costs have increased over 600 percent. She expects that she will end the year with […]

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Grandmother With Breast Cancer Asks For Help
11 months Ago

Grandmother With Breast Cancer Asks For Help

Before Becky Frank was diagnosed with stage 3 breast cancer, she was energetic and spent time with her five grandchildren. When Frank was diagnosed, her daughter, Cherlyn Edwards, was sad but determined to help her fight the disease. She found her mother an oncologist who specializes in triple negative breast cancer, the aggressive and difficult […]

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Man Receives Surprise Bill After Going To In-Network Hospital
12 months Ago

Man Receives Surprise Bill After Going To In-Network Hospital

Steve Zangla waited as long as he could but eventually his stomach pain became unbearable. Steve and his wife Colleen went to the emergency room at Riddle Hospital in Media, PA. The Zanglas had positive experiences at the hospital before. Once there, the Zanglas learned that Steve had a kidney stone. Weeks later, they were […]

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ER Visit Lands Utah Man With $80,000 In Bills
12 months Ago

ER Visit Lands Utah Man With $80,000 In Bills

Richard Wyler was working on a construction project near Las Vegas, when he awoke with a stomach ache. He thought it was probably food poisoning and got himself to work the next day, according to KSL. “I probably wouldn’t have gone to the emergency room unless my work made me,” Wyler said. “I honestly didn’t […]

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Cancer Treatment With Fewer Side Effects Often Denied By Insurance
12 months Ago

Cancer Treatment With Fewer Side Effects Often Denied By Insurance

In a recent op-ed in the Houston Chronicle, a cancer patient recounted his battle with his insurer, Blue Cross Blue Shield. When Randy Montgomery was diagnosed with oral cancer last year, it sparked a whirlwind of tests, decisions, and significant life changes. The same treatments that would fight off the cancer carried “life-altering side effects […]

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Father Gives Update On Son’s Treatment After Battle For Coverage
12 months Ago

Father Gives Update On Son’s Treatment After Battle For Coverage

In April, CQC wrote about Matthew Timion’s fight to get his adopted son coverage for acute psychological issues. After years of battling with the state, Timion is giving an update on his son’s health. At age 10, Timion’s son began to act out aggressively and threaten violence. At one point, Timion was bringing his son […]

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A Year Later, Las Vegas Survivors Battle Insurance Bills
12 months Ago

A Year Later, Las Vegas Survivors Battle Insurance Bills

A year after the deadly mass shooting at the Route 91 concert in Las Vegas, survivors are still dealing with the aftermath. Even for many of the fully-insured survivors, mounting medical bills are part of a new reality, Las Vegas Review-Journal reports. Rose Janise has been dealing with the medical bills for her daughter, Rylie […]

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Family Battling TennCare, Facing Devastating Decisions To Get Care For Daughter
12 months Ago

Family Battling TennCare, Facing Devastating Decisions To Get Care For Daughter

Photo by Heidi de Marco/KHN Adam and Rondi Kauffmann are battling TennCare, Tennessee’s Medicaid program, to get care for their disabled daughter, FOX 17 News reports. Adelaide, the couple’s 10-month-old daughter, has Spinal Muscular Atrophy Type 1. The disease leads to a weakness and lack of control over the muscles and causes breathing concerns. Before […]

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Consumer Cost Concerns – In Their Own Words
12 months Ago

Consumer Cost Concerns – In Their Own Words

As consumers are impacted by high deductibles, surprise bills, balance billing, and other health care challenges, they have taken to social media to discuss their experiences. This is an opportunity for consumers to air grievances, ask for help, and share their stories. In our new series, “Consumer Cost Concerns – In Their Own Words,” CQC […]

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Consumers Lose When Hospitals And Insurers Agree To Secret Contracts
1 year Ago

Consumers Lose When Hospitals And Insurers Agree To Secret Contracts

A story in the Wall Street Journal reveals large hospitals and hospital systems have been using secret contracts with insurance companies to restrict cost saving opportunities for consumers. Hospitals do anything from demanding insurers include their facilities in insurance plans to masking their prices from consumers. As the Wall Street Journal reports: Dominant hospital systems […]

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Virginia Family Hit With Huge Surprise Medical Bill After Out-Of-Network Treatment at In-Network ED
1 year Ago

Virginia Family Hit With Huge Surprise Medical Bill After Out-Of-Network Treatment at In-Network ED

A Virginia family received a huge hospital bill after their teenage son was rushed to the hospital after a baseball pitch hit him in the face. As NBC Washington reports: A family unknowingly let an out-of-network doctor treat their teenage son and wound up with a bill for tens of thousands of dollars. Zack Hamilton, […]

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Many Consumers Receive Surprise Medical Bills, Most Blame Insurers
1 year Ago

Many Consumers Receive Surprise Medical Bills, Most Blame Insurers

Consumers across the country continue to face the harsh reality of expensive medical bills. Reicedo Concepcion does not remember many details about the day he was struck by a car. The incident landed him the in hospital with stitches and five broken ribs, KSAT reports. “Now I can’t take air,” he said, explaining how it’s […]

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Charlottesville Consumers Band Together Against High Premiums
1 year Ago

Charlottesville Consumers Band Together Against High Premiums

  Photo by Heidi de Marco/KHN A group of Charlottesville consumers have banded together to take on the area’s high health insurance rates, The Washington Post reports. After 2018 brought soaring premiums on the Affordable Care Act’s individual market place, Ian Dixon found himself questioning the high prices. Dixon, an app developer, was facing a […]

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Hospital ERs To Blame For High Health Care Costs
1 year Ago

Hospital ERs To Blame For High Health Care Costs

A recent New York Times column highlighted the role of hospital emergency rooms in ever-increasing health care costs. Glenn Melnick, a professor of public policy at the University of Southern California’s Schaeffer Center for Health Policy and Economics, wrote that well-intentioned regulations have given hospital ERs incredible leverage to price services however they wish. Most states have […]

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New Study Suggests Bundled Payments Are Working
1 year Ago

New Study Suggests Bundled Payments Are Working

According to a new study, the ACA’s bundled payment program is working better than some expected, Vox reports. The program pays hospitals a single, flat amount for joint replacement surgeries. The program aimed to get hospitals to lower the costs of these surgeries while maintaining or improving consumers’ quality of care. The hope for bundled […]

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Hospital Group Creates Generic Drug Company to Lower Prices for Consumers
1 year Ago

Hospital Group Creates Generic Drug Company to Lower Prices for Consumers

In an effort to take control over parts of the drug-supply chain, a group of major hospitals has started a generic drug company, named Civica Rx, the The Washington Post reports. Several hospital leaders said shortages and price spikes on old drugs are managed on a near-daily basis. The cost isn’t just the price of […]

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Even Small Medical Debts Cause Complications For Consumers
1 year Ago

Even Small Medical Debts Cause Complications For Consumers

A new study highlights how even small medical debts can have lasting impacts, Associated Press reports. The study, published in Health Affairs, highlights how vulnerable consumers are to medical bills, especially surprise bills or balance bills. When sent to collections, even small medical bills can impact consumers’ credit scores and financial health. Researchers found that […]

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HHS Takes Steps To Ensure Safe Nursing Homes
1 year Ago

HHS Takes Steps To Ensure Safe Nursing Homes

Photo by Heidi de Marco/KHN The Department of Health and Human Services’ inspector general has launched an examination into skilled nursing facilities to ensure they are meeting Medicare’s minimum staffing requirements, Kaiser Health News reports. This attempt to ensure that nursing homes provide safe, quality care to patients follows a KHN and New York Times […]

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These Pharma Bros Specialize in How to Raise Drug Prices
1 year Ago

These Pharma Bros Specialize in How to Raise Drug Prices

Todd Smith and Benjamin Bove have worked with pharmaceutical companies across the country, offering  a “sure-fire fix” to increase revenues by exploiting loopholes and raising prices, Bloomberg reports. After Smith and Bove were consultants at Novum Pharma, a tube of Alcortin A, a skin gel, jumped from $189 in 2015 to $7,968. At another company, […]

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After Heart Attack, Teacher Is Billed Twice His Annual Salary
1 year Ago

After Heart Attack, Teacher Is Billed Twice His Annual Salary

Before Drew Calver had his heart attack in April 2017, he considered himself to be in good health. At 44, Calver was an avid swimmer and had just completed an Ironman triathlon a few months before. Kaiser Health News reports on the health scare that upended Calver’s life and the subsequent bill that he never […]

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Breast Cancer Treatment Results In Surprise Bills
1 year Ago

Breast Cancer Treatment Results In Surprise Bills

After a routine mammogram, Kathy Salerno was called back for a second mammogram, an ultrasound, and a biopsy. The tests confirmed any family’s fear: breast cancer. Salerno’s surgery was successful, removing the tumor and lymph node with good margins. Subsequent tests came back clear, and Salerno’s doctors recommended radiation to kill any cancer left in […]

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Growing Number Of Consumers Turn To Alternative Plans
1 year Ago

Growing Number Of Consumers Turn To Alternative Plans

As expensive premiums, high deductibles, and surprise medical bills continue to impact consumers, more are turning to coverage alternatives to “rig their own safety nets,” Bloomberg reports. The Kaiser Family Foundation has found that most American families that do not have coverage find it too expensive. This was the case for Lindsie and Chris Bergevin. […]

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Consumers Don’t Understand Insurance Plans Or Bills, Survey Shows
1 year Ago

Consumers Don’t Understand Insurance Plans Or Bills, Survey Shows

Photo by Heidi de Marco/KHN A new survey from Bankrate is highlighting just how opaque and confusing insurance coverage and subsequent bills are for many Americans. The survey found that 41 percent of consumers that received medical treatments were surprised by the cost. The story is all too familiar: someone heads to the doctor, gets […]

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Consumers Could Save Money By Avoiding Convenience Drugs
1 year Ago

Consumers Could Save Money By Avoiding Convenience Drugs

Photo by Heidi de Marco/KHN A new group of drugs may be unnecessarily costly for consumers. The drugs, nick-named “convenience drugs,” combine the ingredients of two common, generic medications to create a more expensive alternative. Axios found that many convenience drugs could be replaced by a combination of generics and over-the-counter medication for around $20. […]

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Not Even Hospitals Know True Cost Of Care
1 year Ago

Not Even Hospitals Know True Cost Of Care

Graph by Wall Street Journal Pinning down the price of care can be difficult, if not impossible, for consumers. The Wall Street Journal reports even the hospitals that provide the care don’t know its true cost. After hearing of potential payment changes, Gundersen Health System’s hospital in La Crosse, WI, decided to track the costs […]

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Consumers’ Copay Often More Expensive Than The Drug
1 year Ago

Consumers’ Copay Often More Expensive Than The Drug

  Gretchen Liu was on vacation in China when she suffered a mini stroke. When she returned to San Francisco, her doctor prescribed a generic blood pressure medication, telmisartan. Liu and her husband Z. Ming Ma used their insurance to buy a 90-day supply of the drug through Anthem’s online pharmacy run by Express Scripts. […]

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New Studies Examine Impact Of Medical Bills On Consumers
1 year Ago

New Studies Examine Impact Of Medical Bills On Consumers

Two new studies examine the impact of medical bills on consumers. Together, they provide a glimpse into what many consumers face after receiving medical care. Contrary to the reason many individuals purchase health insurance, it does not a guarantee protection against high medical bills, USA Today reports. A Bankrate survey of 1,000 individuals found that […]

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Same Test, Same Patient, Same Insurance – Two Prices
1 year Ago

Same Test, Same Patient, Same Insurance – Two Prices

  Previously, Consumers for Quality Care has reported on the wild price discrepancies for the same tests at different facilities, like when Benjamin Hynden paid 33 times more to receive a CT scan from a hospital than from an imaging center. Now, The Philadelphia Inquirer has reported on a man who paid 18 times more […]

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More Consumers Turn To Crowdsourcing To Help Pay Medical Bills
1 year Ago

More Consumers Turn To Crowdsourcing To Help Pay Medical Bills

Photo by Heidi de Marco/KHN More consumers are turning to crowdsource fundraising sites, like GoFundMe, to help pay for medical bills they have trouble affording, MPR News reports. Rob Soloman, the company’s CEO, says that medical fundraisers now account for one third of the site’s campaigns. Often, it’s family members or friends – like Tammy […]

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Insurer Reverses Pre-approval For Cancer Drug
1 year Ago

Insurer Reverses Pre-approval For Cancer Drug

As soon as Michele Brough was diagnosed with Stage 3 breast cancer, her doctors wanted move forward with treatment. Brough’s oncologist quickly reached out to her insurance company, Anthem Blue Cross Blue Shield, to apply for pre-approval for a drug to strengthen her immune system as she underwent chemotherapy. Los Angeles Times reports that Brough […]

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Blue Cross Blue Shield Begins Controversial ER Policy In Texas
1 year Ago

Blue Cross Blue Shield Begins Controversial ER Policy In Texas

  Blue Cross Blue Shield will begin a controversial emergency room policy in Texas, Houston Chronicle reports. The insurer will no longer cover some out-of-network ER visits if it determines that the patient should have sought treatment elsewhere. The policy change will impact roughly 500,000 Texans. Blue Cross Blue Shield of Texas said medical directors […]

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Cost Of Childhood Cancer Follows Survivors Into Adulthood
1 year Ago

Cost Of Childhood Cancer Follows Survivors Into Adulthood

A new study from St. Jude Children’s Research Hospital is shedding light on the long-term financial impact of childhood cancer. The study found that the long-term health risks associated with childhood cancer treatments, as well as screenings for recurrences and new complications, carry high financial tolls for children and their families. Kristi Lowery, who participated […]

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Flawed Assumptions Behind High Deductible Plans Leave Consumers Paying More
1 year Ago

Flawed Assumptions Behind High Deductible Plans Leave Consumers Paying More

The prevalence of high deductible health care plans has largely been propelled by the idea that consumers would be more responsible with their health care spending if they had a larger stake in it. The logic assumes consumers know what kind of care is necessary and what is superfluous. The reality of how consumers use […]

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Hospital Care Is Significant Portion Of Health Care Spending For Consumers
1 year Ago

Hospital Care Is Significant Portion Of Health Care Spending For Consumers

High hospital prices have been a strain on the American health care system, Axios reports. Ever-increasing hospital spending has a major impact on consumers. CMS data shows that hospital care costs more than $3,300 per capita, roughly three times that of prescription drug spending. Chart by Axios In total, hospital and doctor services account for […]

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Administration Scraps Medical Best Practice Guideline Website
1 year Ago

Administration Scraps Medical Best Practice Guideline Website

The Trump administration has scrapped the National Guideline Clearinghouse website, guideline.gov. The website housed an online database of best practice guidelines for doctors, other medical professionals, and researchers, Vox reports. The National Guideline Clearinghouse’s repository of evidence-based clinical practice guidelines and related documents was “a one-stop shop for doctors who were trying to figure out […]

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CMS Move Could Raise Drug Prices, Hurt Consumers
1 year Ago

CMS Move Could Raise Drug Prices, Hurt Consumers

  Photo By Heidi de Marco/KHN The Center on Budget and Policy Priorities is highlighting how a recent move from Centers for Medicare & Medicaid Services (CMS) could increase drug prices and hurt consumers. Recently, CMS rejected a Massachusetts proposal to limit consumers’ access to prescription drugs. After rejecting the proposal, however, CMS suggested even […]

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Divorce Or Care? Family Considers Extreme Measures To Pay For Daughter’s Care
1 year Ago

Divorce Or Care? Family Considers Extreme Measures To Pay For Daughter’s Care

  Maria and Jake Grey’s daughter Brighton has a rare chromosomal disorder called Wolf-Hirschhorn Syndrome. The disorder means that Brighton, who is six, needs round-the-clock care. Still a newborn by developmental standards, Brighton has seizures, vision, hearing, heart and kidney problems, and more. The Greys are considering divorce as an answer to their health care […]

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NYT Editorial Examines The State Of Medicaid Coverage In The US
1 year Ago

NYT Editorial Examines The State Of Medicaid Coverage In The US

  An editorial in The New York Times examines the state of Medicaid coverage in the United States and criticizes the ideology behind work requirement programs. District Court Judge James Boasberg recently ruled in favor of a group of 16 Kentuckians, including a law student with a heart condition and a housekeeper with rheumatoid arthritis, […]

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Why Are ER Bills So High?
1 year Ago

Why Are ER Bills So High?

Vox’s Sarah Kliff recently sat down with PBS to discuss some of the common, hidden costs in consumers’ emergency room bills. Kliff is currently working on a project that collects, examines and reports on consumers’ ER bills, and exposes their hidden costs. Kliff, who has collected more than 1,300 medical bills, discussed what is hurting […]

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New Venture Could Benefit Consumers
1 year Ago

New Venture Could Benefit Consumers

Consumers may see big benefits from a new health venture that seeks to innovate the American health care system. The project, established by Amazon, Berkshire Hathaway, and JP Morgan, is looking for ways to improve the care received by those on their plans. An initial focus of the efforts is eliminating middlemen to cut costs […]

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Family Vacationing In US Receives $18K Hospital Bill For Child’s Nap, Formula
1 year Ago

Family Vacationing In US Receives $18K Hospital Bill For Child’s Nap, Formula

  A South Korean family received a hospital bill for nearly $20,000 for a nap and baby formula after an accident landed their son in the ER. Jang Yeo-im was on vacation in San Francisco when her 8-month son, Park Jeong-whan fell off the bed, hitting his head. Although there was no blood, Jeong-whan was […]

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Consumers Face Consequences Of High Deductible Insurance Plans
1 year Ago

Consumers Face Consequences Of High Deductible Insurance Plans

Carla and John Jordan thought they were prepared if one of their family members became sick. The family had insurance through Carla’s employer, which they believed would cover them if anything were to happen. But a disastrous health year taught the family they were wrong, Bloomberg reports. Carla needed a gallbladder operation. Her husband John […]

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Type I Diabetic Recounts Her Struggle With Insurance Coverage
1 year Ago

Type I Diabetic Recounts Her Struggle With Insurance Coverage

Photo by Heidi de Marco/KHN Kylah Goodfellow Klinge, who has battled Type I Diabetes since her early 20s, wrote a piece for STAT where she recounted her experiences with insurance coverage, echoing many common consumer frustrations. Goodfellow Klinge was about to graduate college when she received her diagnosis. [J]ust before my college graduation, odd symptoms […]

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Cost Of Emergency Room Visits Doubles Over 8 Years
1 year Ago

Cost Of Emergency Room Visits Doubles Over 8 Years

A new study has found that while the number of emergency room visits has stayed consistent, the cost of these visits has nearly doubled, The Houston Chronicle reports. In 2016, the average amount spent nationally by insurers and patients for emergency room visits was $247 per insured person. In 2009 it was $125, the Health […]

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New Missouri Law Aims To Protect Consumers
1 year Ago

New Missouri Law Aims To Protect Consumers

  A new Missouri law aims to protect consumers from Anthem’s emergency room policy, News-Leader reports. The controversial policy, which CQC has previously reported on, states that consumers’ claims for emergency room visits can be retroactively denied if Anthem does not consider the visit an emergency. Since implementing the policy in six states, Anthem has […]

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Man Diagnosed With ALS Fights Insurer To Get Bed He Needs
1 year Ago

Man Diagnosed With ALS Fights Insurer To Get Bed He Needs

  A little more than a year after Nick Williams was diagnosed with ALS, he had to leave his job of 14 years as a high school wrestling coach. Williams coached his last season from the confines of a wheelchair, which he found himself needing just 3 months after his diagnosis. Since then, many every […]

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Patient Advocates Question New Insurer Practices
1 year Ago

Patient Advocates Question New Insurer Practices

Nathaniel Killgore, born with hemophilia, was in the process of moving to a new state when he began to bleed internally in his knees and arms. Killgore was in pain and having trouble getting around. He knew he needed a clotting factor to help ease the bleeding and pain. To get his life-sustaining medication, Killgore […]

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Mom With Breast Cancer Hurt By Short-Term Insurance
1 year Ago

Mom With Breast Cancer Hurt By Short-Term Insurance

Amanda Schornhorst wasn’t too alarmed when she felt a lump in her breast. Six years prior, she had been diagnosed with cysts, WTHR reports. She expected a mammogram to show the same thing this time around. When Schornhorst went to the doctor for a routine check-up a few months later, she was not surprised when […]

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Anthem Tells Woman Oncologist Is In Network, Then Reverses Course
1 year Ago

Anthem Tells Woman Oncologist Is In Network, Then Reverses Course

Photo by Heidi de Marco/KHN Tammy Oliver was diagnosed with Stage IV cancer in 2015. Her doctors told her there was not much they could do, but she started new medications and hoped for a miracle, WTHR reports. The injection Oliver started receiving was around $9,000 a month. Tammy Oliver and her husband Pastor Brent […]

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Man Receives Surprise Medical Bill After Being Attacked, Left Unconscious
1 year Ago

Man Receives Surprise Medical Bill After Being Attacked, Left Unconscious

Scott Kohan was brutally attacked in January. When he came to, after the attack, he was laying in an emergency room. The attack had left him unconscious and he was transported to the hospital after witnesses called 911. Kohan called for the nurse, who explained his injuries and that he would need jaw surgery. Kohan […]

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Anthem Continues Harmful Denial Practices
1 year Ago

Anthem Continues Harmful Denial Practices

Jim Burton was working in his garage when he felt a pain in his back and dropped to his knees. Burton contacted a friend who is an EMT, who advised Burton to go to the emergency room. They worried he may have slipped a disk in his back. Luckily, the doctors at the ER found […]

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ALS Patients Lose Time Waiting For Insurer Approval
1 year Ago

ALS Patients Lose Time Waiting For Insurer Approval

Photo by Heidi de Marco/KHN Sarah Benoit has been waiting for her insurance company to approve the drug her doctors tell her could help slow the progression of her ALS. The drug, called Radicava, was approved by the FDA and prescribed by her doctors. However, her insurer Blue Cross of California will not approve the […]

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Mom Denied New Liver Writes Plea to Insurer’s CEO
1 year Ago

Mom Denied New Liver Writes Plea to Insurer’s CEO

Erica Zak was diagnosed with cancer when her daughter was only a week old. What she thought were pregnancy pains turned out to be colon cancer, which metastasized to her liver. Zak underwent treatment and the cancer was successfully removed from her colon, but a microwave ablation surgery to remove tumors from her liver went […]

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Surprise Medical Bills Continue to Plague Consumers
1 year Ago

Surprise Medical Bills Continue to Plague Consumers

Photo by Heidi de Marco/KHN A Colorado man’s credit score was threatened after he received a surprise medical bill for out-of-network doctors at an in-network hospital. Jeff Woodard was hospitalized after a horse-riding accident and ran up hundreds of thousands in medical bills, which his insurer covered. But then he was hit with surprise medical […]

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Hospitals Make Big Profit Off Of Low Cost Items
1 year Ago

Hospitals Make Big Profit Off Of Low Cost Items

A woman in Oklahoma was charged $15,075 for four screws in her foot. In 2017, Sherry Young had surgery on her shoulder and foot at Oklahoma University Medical Center. Her insurer, BlueCross BlueShield of Oklahoma originally balked at paying her $115,000 bill for the surgeries. As a result, Young examined her bill to determine why […]

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Hospitals Fight Anthem’s ER, Imaging Policies
1 year Ago

Hospitals Fight Anthem’s ER, Imaging Policies

As Consumers for Quality Care has reported, last year Anthem announced that consumers’ emergency room visits would not be automatically covered. Instead, the insurer said it would evaluate whether the patient’s issue constituted an emergency, and cover the care accordingly. Consumers, consumer advocates, and politicians alike have been vocal about their apprehension about the policy’s […]

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Woman Charged More Than $5,000 For Basic First Aid Supplies
1 year Ago

Woman Charged More Than $5,000 For Basic First Aid Supplies

A woman was charged $5,751 for an ice pack and a bandage, according to Vox. In 2016, Jessica Pell fainted, fell and hit her head, and cut her ear. She went to emergency room where she received an ice pack and bandage for her ear. Pell was wary of receiving surprise medical bills, so she […]

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American College Of Emergency Physicians Starts New Campaign Against ER Rule
1 year Ago

American College Of Emergency Physicians Starts New Campaign Against ER Rule

The American College of Emergency Physicians (ACEP) has launched the next part of its campaign against Anthem Blue Cross Blue Shield’s emergency room coverage policy. CQC wrote about this harmful policy and its impact on consumers in the past. In this new iteration of its campaign, ACEP released two videos depicting how Anthem’s policy might […]

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Surprise Medical Bills Sent To Newborn Babies
1 year Ago

Surprise Medical Bills Sent To Newborn Babies

Hospitals are sending large bills to newborn babies, Splinter News reports: There are frantic posts about it on new mom message boards all over the internet: About $5,000 charges for “newborn nursery” services billed to the baby when it never left the hospital room, or surprise charges to infants women thought were covered under their […]

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Doctors Argue ‘Step Therapy’ Harmful For Patients
1 year Ago

Doctors Argue ‘Step Therapy’ Harmful For Patients

Doctors are speaking out against insurance companies’ use of ‘step therapy,’ in treatment approvals.  Insurers argue that the practice helps cap increasing drug costs but doctors argue that the practice is making their patients worse. Step therapy requires patients to try cheaper drugs before moving on to more expensive medications. Doctors are highlighting stories like […]

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Tennessee Man Fights Insurance Company For Prosthetic Arm
1 year Ago

Tennessee Man Fights Insurance Company For Prosthetic Arm

Tommy Jones lost his right arm in a farming accident when he was just 17. For the last 35 years, Jones has worked as a heavy equipment operator. Thanks to a prosthetic arm, he has been able to work and live independently. Now, however, Jones has had to fight his insurance company, Blue Cross Blue […]

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Lapses In Mental Health Parity Laws Hurt Consumers
1 year Ago

Lapses In Mental Health Parity Laws Hurt Consumers

Consumers and advocates are speaking out against lapses in the nation’s mental health parity laws, which are supposed to ensure mental health and substance abuse coverage in health care. Despite the law’s passage ten years ago, disparity persists, Chicago Tribune reports. Matthew Timion’s adopted son was 10 when he started to act out, often violently, […]

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Consumer Receives the Same Treatment at Two Hospitals, But One Costs 33 Times More
1 year Ago

Consumer Receives the Same Treatment at Two Hospitals, But One Costs 33 Times More

Benjamin Hynden had been experiencing mild discomfort in his abdomen for a  few weeks when he made an appointment to see his internist last fall. The doctor recommended that Hynden get a CT scan at a local imaging center, Kaiser Health News reports. Hynden received the CT scan, which was inconclusive, and paid a $268 […]

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Senators Want Answers About  1400 Percent Increase in Price of Cancer Drug
1 year Ago

Senators Want Answers About 1400 Percent Increase in Price of Cancer Drug

Three senators have demanded answers about price increases for a decades-old cancer drug. According to The Hill: The drug in question, lomustine, was introduced in 1976 to treat brain tumors and Hodgkin lymphoma. Lomustine, which has no generic competition, cost $50 for a capsule with the highest dose in 2013. Now a capsule with the […]

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Iowa Legislature Approves Bill That Could Jeopardize Health Consumers
1 year Ago

Iowa Legislature Approves Bill That Could Jeopardize Health Consumers

Legislation in Iowa to allow Affordable Care Act-exempt plans could leave consumers vulnerable. The bill would allow certain health plans to be exempt from the law’s mandates, Des Moines Register reports. It would allow small employers to band together and buy insurance through association health plans, which can charge more, deny coverage for pre-existing conditions […]

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New Medicare Cards Aim To Reduce Identity Theft
1 year Ago

New Medicare Cards Aim To Reduce Identity Theft

Photo by Heidi de Marco/KHN Next month, Medicare enrollees will receive a new Medicare card that will help prevent scams. According to Kaiser Health News: The new cards address these concerns by removing each member’s Social Security number and replacing it with a new, randomly generated 11-digit “Medicare number” (some capital letters are included). This […]

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UnitedHealthcare’s New, Harmful ER Policy
1 year Ago

UnitedHealthcare’s New, Harmful ER Policy

The nation’s largest health insurer has announced a new ER policy that could have negative consequences for consumers. UnitedHealthcare will analyze claims submitted by hospitals to determine if the ER had upcoded. According to Naples Daily News: UnitedHealthcare will be using an “emergency department claim analyzer tool” that will determine the appropriate coding “based on […]

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Two Studies Find Hospitals Upcharge Cancer Bills
2 years Ago

Two Studies Find Hospitals Upcharge Cancer Bills

Photo by Heidi de Marco/KHN Two recent studies found that hospitals routinely inflate costs related to cancer care, sometimes charging upwards of five times more, MedScape reports. A study by Martin A. Makary and colleagues, published in the American Journal of Managed Care (AJMC), found that hospitals routinely charge patients more for cancer care than […]

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Anthem Under Scrutiny For New Anesthesia Policy
2 years Ago

Anthem Under Scrutiny For New Anesthesia Policy

Photo by Heidi de Marco/KHN In a recent letter to eye surgeons, Anthem introduced a new anesthesia policy, writing that they do not find that, in most cases, an anesthesiologist or nurse anesthetist is medically necessary for procedures. This means that surgeons preforming cataract surgery may soon have to monitor their patient’s anesthesia at the […]

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Hospital Offering Bank Loans On The Spot Could Put Consumers On The Hook For More Health Care-Related Costs
2 years Ago

Hospital Offering Bank Loans On The Spot Could Put Consumers On The Hook For More Health Care-Related Costs

A recent Kaiser Health News article highlights an increasingly popular trend that is potentially harmful for consumers. In a new scheme designed to ensure hospitals are getting paid for the services they provide, the facilities are pairing with lending services and offering patients loans on the spot.  Private doctors’ offices and surgery centers have long […]

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Consumers for Quality Care Hosts Telebriefing on AHPs
2 years Ago

Consumers for Quality Care Hosts Telebriefing on AHPs

Consumers for Quality Care hosted a telebriefing on Thursday, Feb. 22, with speakers from the Georgetown University Health Policy Institute and the DC Health Benefit Exchange Authority, who provided an overview of the Department of Labor (DOL) proposed rule on Association Health Plans (AHPs), and discussed the policy implications with dozens of stakeholders who joined […]

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Idaho Consumers Could Be Stuck With Less Coverage If They Opt For New, Cheaper Blue Cross Plans
2 years Ago

Idaho Consumers Could Be Stuck With Less Coverage If They Opt For New, Cheaper Blue Cross Plans

Blue Cross of Idaho will sell five health insurance plans that do not comply with ACA standards, The Idaho Statesman reports. The announcement comes after Idaho’s Governor Butch Otter signed a controversial executive order allowing insurers to create “state based” plans. These plans would be required to meet lower state requirements. “We’re excited that they’ve […]

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Anthem Makes Some Changes To Harmful ER Policy; Doesn’t Go Far Enough
2 years Ago

Anthem Makes Some Changes To Harmful ER Policy; Doesn’t Go Far Enough

After facing pushback from hospitals, patients, and health care advocates, Anthem has decided to modify its emergency room coverage policy but many do not believe the insurer has gone far enough. As Consumers for Quality Care reported, last year Anthem announced that consumers’ emergency room visits would not be automatically covered. Instead, the insurer said […]

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California Investigates Aetna’s Coverage Denial Practices
2 years Ago

California Investigates Aetna’s Coverage Denial Practices

After Aetna’s former medical director admitted that he did not review patients’ records when approving or denying a claim, the state of California has launched an investigation into the company’s patient claims review process, CNN reports. Dr. Jay Ken Iinuma was deposed as part of a lawsuit against the insurer brought by Gillen Washington, a […]

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Consumers Stuck With Big Bills After ER Trips
2 years Ago

Consumers Stuck With Big Bills After ER Trips

More and more consumers are finding themselves saddled with expensive emergency room bills as a result of Anthem’s decision to stop covering visits it deems to be non-emergencies.  That’s exactly what happened to Kimberly Fister-Mesch. According to Consumer Reports, Fister-Mesch woke up in the middle night with a severe headache. She took Motrin and Tylenol, […]

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Consumers Hit By Surprise Medical Bills Often Can’t Pay
2 years Ago

Consumers Hit By Surprise Medical Bills Often Can’t Pay

As consumers continue to receive surprise medical bills, they often do not have the money to pay, Fierce Healthcare reports. After arriving at an in-network hospital, consumers can be unknowingly treated by out-out-network physicians. That’s exactly what happened to Reid Rupp, who received a $17,000 bill from an out-of-network plastic surgeon after a medical emergency […]

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Insurer Goes Against Doctor’s Recommendation, Denies Cancer Treatment Coverage
2 years Ago

Insurer Goes Against Doctor’s Recommendation, Denies Cancer Treatment Coverage

A St. Louis man is fighting his insurance company after it went against his doctor’s treatment advice and denied his treatment for lung cancer, KMOV reports. After undergoing surgery to remove his left lung, David Starzyk’s doctor developed a treatment plan for his other lung. His doctors at Siteman Cancer Center made plans for radiation […]

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Cuts To Medicaid Transportation Services Put Consumers At Risk
2 years Ago

Cuts To Medicaid Transportation Services Put Consumers At Risk

Photo By Heidi de Marco/KHN The Trump administration recently announced changes to Medicaid’s non-emergency medical transportation (NEMT) services, allowing states to apply for waivers so they are no longer required to provide this key benefit. But, as Kaiser Health News reports, NEMT services have been an integral part of the Medicaid program since its inception […]

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Family Battles Insurer For Infant’s Life-Saving Procedure
2 years Ago

Family Battles Insurer For Infant’s Life-Saving Procedure

4-month old Jensen Kittle was born with Severe Combined Immunodeficiency (SCID), a life-threatening genetic disorder that leaves Jensen with virtually no immune system to battle every day germs. According to local CBS affiliate WRGB: “Without an immune system he has no ability to fight against the flu, the common cold, even wearing the wrong fragrance […]

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Consumers Feel The Pain Of Anthem’s New ER Policy
2 years Ago

Consumers Feel The Pain Of Anthem’s New ER Policy

As a part of Vox’s dive into emergency room billing, Sarah Kliff recently reported on how Anthem’s new emergency room policy – which essentially requires patients to diagnose themselves in order to ensure their condition is serious enough to be deemed an emergency by Anthem, and therefore covered by their insurance – is impacting consumers. […]

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Hospital Service Reductions Negatively Impact Rural Consumers
2 years Ago

Hospital Service Reductions Negatively Impact Rural Consumers

Photo By Heidi de Marco/KHN Hospital conglomerates are changing their business models, consolidating care at regional hospitals, and often cutting services at more remote facilities. As services are cut from these facilities, they become de facto outpatient clinics. Hospital executives argue that the changing medical landscape has made long inpatient stays more sparse and hospitals […]

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Consumers In Idaho Could Get Stuck With Bare Bones Plans
2 years Ago

Consumers In Idaho Could Get Stuck With Bare Bones Plans

Idaho has announced it will take formal steps to allow insurance companies to sell non-compliant plans on the state’s ACA market place, the Associated Press reports. The change means some consumers who opt for cheaper plans could end up with health insurance that doesn’t cover their needs. Under Idaho’s guidelines, insurers can offer plans that […]

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Centene Sued Over Narrow Network Plans
2 years Ago

Centene Sued Over Narrow Network Plans

A new lawsuit claims that health insurance company Centene Corporation provides plans that have less coverage than advertised. The lawsuit claims the insurance company’s slim coverage makes it difficult, if not impossible, for consumers to find adequate care, according to Bloomberg. The company misled customers about the number of doctors covered under its health plans, […]

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Aetna Agrees to Pay $17 Million Settlement for Revealing HIV Statuses of Thousands of Policy-holders
2 years Ago

Aetna Agrees to Pay $17 Million Settlement for Revealing HIV Statuses of Thousands of Policy-holders

Health insurance giant Aetna has agreed to a $17 million settlement after it breached consumers’ privacy in an incident that revealed the HIV statuses of thousands of policy-holders, according to The Associated Press. Consumers for Quality Care reported on the breach over the summer. Court documents say the Hartford, Connecticut-based company sent a mailing in […]

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Mental Health and Addiction Treatment Database Freeze Could Hurt Consumers
2 years Ago

Mental Health and Addiction Treatment Database Freeze Could Hurt Consumers

The Trump administration has frozen the National Registry of Evidence-based Programs and Practices (NREPP), a national database of mental health and substance abuse treatments and interventions, a move that could have negative consequences for consumers. Health professionals and community groups use the database to identify resources to help individuals in need of these services. According […]

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Allowing Medicaid Work Requirements Will Harm Most Vulnerable Americans
2 years Ago

Allowing Medicaid Work Requirements Will Harm Most Vulnerable Americans

Photo by Heidi de Marco/KHN The Trump administration announced it would allow states to implement work requirements for Medicaid recipients, the Washington Post reports. The change signifies a fundamental shift in the program’s policy. At the time of the announcement, 10 states had already requested federal permission to add work requirements to their Medicaid programs […]

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Samantha Bee Highlights Failing Maternity Care
2 years Ago

Samantha Bee Highlights Failing Maternity Care

Comedian Samantha Bee recently highlighted how American hospitals are failing on maternity care. In the segment, Bee focused on a number of stories that examine how the U.S. has the worst maternal mortality rate in the developed world. A 2015 statistic found that American women die in childbirth at twice the rate of women in […]

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Sen. McCaskill Requests Information On Anthem’s ER Policy Change
2 years Ago

Sen. McCaskill Requests Information On Anthem’s ER Policy Change

Sen. Claire McCaskill has requested information from insurance giant Anthem over a policy change that impacts Missouri consumers’ emergency room coverage, according to St. Louis Business Journal. As Consumers for Quality Care has previously reported, Anthem has told patients in a number of states that their ER visits may no longer be covered, if they […]

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Special Enrollment Periods Allow Some To Still Enroll In A 2018 Health Plan
2 years Ago

Special Enrollment Periods Allow Some To Still Enroll In A 2018 Health Plan

Despite the Affordable Care Act (ACA) open enrollment period ending on December 15, some consumers may still be eligible to enroll in a health plan for 2018. Most residents in states that established their own marketplaces have later deadlines, according to the Kaiser Family Foundation. State-based Marketplaces (SBMs) have flexibility to set their own dates […]

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Consumers Battle Against Hospital-Owned Debt Collectors
2 years Ago

Consumers Battle Against Hospital-Owned Debt Collectors

A Florida woman’s life was thrown into turmoil after she was hospitalized and received a massive bill that she couldn’t pay. According to Bloomberg: [Angelia] Fowler had been sick for months in November 2015 when her son finally took her to the emergency room with what turned out to be pneumonia. She spent much of […]

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CQC’s Christensen Discusses The Dismantling Of Massachusetts’ Health Care
2 years Ago

CQC’s Christensen Discusses The Dismantling Of Massachusetts’ Health Care

In a recent Medium column, Consumers for Quality Care board member Donna Christensen discusses the potential dismantling of Massachusetts’ health care system. The Commonwealth, once a national leader on health care, is on the verge of cutting thousands of vulnerable Massachusetts citizens’ coverage. The Massachusetts government recently submitted a waiver request (known as a 1115 […]

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Insurer Under Fire For Rolling Back Coverage of HIV Prevention Medication
2 years Ago

Insurer Under Fire For Rolling Back Coverage of HIV Prevention Medication

Photo by Heidi de Marco/KHN Recently, UnitedHealthcare has come under fire for rolling back coverage of Truvada, a pre-exposure prophylaxis (PrEP) medication.  When used correctly, the drug has at least a 92% success rate in preventing HIV transmission. The drug is normally expensive, and many patients use secondary insurance, such as copay cards or manufacturer […]

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Insurer Denies Teen’s Brain Surgery
2 years Ago

Insurer Denies Teen’s Brain Surgery

Cara Pressman, a 15-year-old with epilepsy, has some tough words for her insurance company after it denied her coverage of a minimally invasive brain surgery. One day when Cara was 9, she incessantly complained of a severe headache.  That night Cara had her first seizure.  When her parents came to her room she was covered […]

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Consumers Are Paying More For ER Facility Fees
2 years Ago

Consumers Are Paying More For ER Facility Fees

The latest installment of Vox’s series on hospital billing and prices examines the monopoly powers of emergency rooms and how consumers are hurt by facility fees. Nearly all emergency room bills include a facility fee, a charge that is applied just for seeking care. According to Vox: Emergency rooms argue that these fees are necessary […]

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Consumers Face High Costs From Overtreatment
2 years Ago

Consumers Face High Costs From Overtreatment

A new Pro Publica report examines how unnecessary procedures and overtreatment are contributing to skyrocketing costs of care. Some doctors and hospitals are performing redundant or unnecessary tests, scans, and procedures. Patients, often lacking knowledge and understanding of why these procedures are being recommend, authorize them. Later, these patients face extreme medical bills for the […]

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CQC Board Member Donna Christensen Speaks To Consumers About Open Enrollment
2 years Ago

CQC Board Member Donna Christensen Speaks To Consumers About Open Enrollment

Consumers for Quality Care board member and former Congresswoman Donna Christensen recently made a number of appearances to inform consumers on how to choose the best plan during open enrollment. Speaking on news networks in Charleston, W. Va.; Chicago; Portland, Oregon; and Seattle, Christensen educated consumers about potential changes and issues to be on the […]

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States Allowed To Get Rid Of Consumer Medicaid Safety-Net Protection
2 years Ago

States Allowed To Get Rid Of Consumer Medicaid Safety-Net Protection

The federal government has allowed Iowa to rollback its retroactive eligibility benefit, making it the fourth state to do so, Kaiser Health News reports. The benefit, which has been a feature of Medicaid for years, allowed for new enrollees’ medical bills to be paid retroactively up to 3 months. The other states include Arkansas, Indiana, […]

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CA Fines Anthem $5 Million Over Consumer Grievances
2 years Ago

CA Fines Anthem $5 Million Over Consumer Grievances

California’s managed care regulator has fined Anthem $5 million, alleging “systemic violations and a long history of flouting the law in regard to consumer complaints,” the Los Angeles Times reports. The fine adds to the $6 million which the insurer has been fined for similar reasons, since 2002. “Anthem Blue Cross’ failures to comply with […]

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Consumers Face Narrow Networks During Open Enrollment
2 years Ago

Consumers Face Narrow Networks During Open Enrollment

As consumers navigate open enrollment for ACA insurance plans, narrow networks continue to be a problem. In an interview with NPR’s Michael Martin, Kaiser Health News’ Julie Rovner explained how narrow networks came about and how they impact consumers: “[When insurers] were starting to put together their plans, they thought, how are we going to […]

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When Hospitals And Doctors Make Mistakes, Consumers Often Pay
2 years Ago

When Hospitals And Doctors Make Mistakes, Consumers Often Pay

A recent Chicago Tribune article examined the lack of accountability from hospitals and doctors related to complications.  These unforeseen costs can be extreme and often become the patient’s responsibility. Whether because of mistakes, infections or plain bad luck, those who go in don’t always come out better.  More than 400,000 Americans die annually in part […]

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Doctor Reveals Truth About Medical Preauthorization Process
2 years Ago

Doctor Reveals Truth About Medical Preauthorization Process

MedPage Today recently published an article by Dr. Milton Packer, describing a peculiar lunch he attended and the lesson he learned about consumer-unfriendly practices insurance companies employ in conducting preauthorization assessments for drugs and medical procedures. Dr. Packer was invited to give a presentation on heart failure to a group of doctors.  He noticed that […]

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Half of Consumers Denied Insurance Coverage For Cholesterol Drug
2 years Ago

Half of Consumers Denied Insurance Coverage For Cholesterol Drug

A recent study of US pharmacy claims found that less than half of patients prescribed a new cholesterol drug receive insurance coverage for the drug. The drug, a PCSK9 inhibitor, has been shown to give patients a 27 percent or lower chance of developing a heart attack, 22 percent lower chance of cardiovascular revascularization, and […]

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Michigan Insurer Stops Coverage For Pain Therapy
2 years Ago

Michigan Insurer Stops Coverage For Pain Therapy

Photo By Heidi de Marco/KHN Alex Ostrowski was just 12 when she suffered a life-threatening accident.  A boat ran over her Jet Ski and she ended up pinned between its propeller and the boat’s diving board. The propeller crushed her hip and pelvis and cut the entire left side of her body.  Miraculously, Ostrowski survived […]

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Anthem’s ER Policy “Completely Unfair To Patients”
2 years Ago

Anthem’s ER Policy “Completely Unfair To Patients”

Consumers in a few states are beginning to grapple with Anthem’s new Emergency Room policy to reject claims that are ultimately deemed as non-emergencies. One Kentucky woman suffered severe stomach pain and was stuck with a bill when the insurer decided she hadn’t been in an emergency situation. According to The Associated Press: Alison Wrenne […]

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CQC Highlights Additional Organizations That Oppose The Massachusetts Waiver
2 years Ago

CQC Highlights Additional Organizations That Oppose The Massachusetts Waiver

As Consumers For Quality Care previously reported, Massachusetts recently submitted a Medicaid 1115 waiver request to the Centers for Medicare & Medicaid Services (CMS) that would make substantial changes for current MassHealth recipients, cutting health care coverage for those who need it most. More than 400 groups submitted comments with serious concerns about the Massachusetts […]

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CQC Joins More than 400 Medical, Consumer and Patient Groups Asking CMS to “Stop the Waiver” in Massachusetts
2 years Ago

CQC Joins More than 400 Medical, Consumer and Patient Groups Asking CMS to “Stop the Waiver” in Massachusetts

By Heidi de Marco/KHN As Consumers For Quality Care previously reported, Massachusetts recently submitted a Medicaid 1115 waiver request to the Centers for Medicare & Medicaid Services (CMS) that would make substantial changes for current MassHealth recipients, cutting health care coverage for those who need it most. More than 400 groups submitted comments with serious […]

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New Project Asks Consumers To Share Their Stories
2 years Ago

New Project Asks Consumers To Share Their Stories

Photo by Heidi de Marco/KHN As extreme hospital and insurer bills continue to be a phenomenon in American healthcare, Vox’s Sarah Kliff has launched a new project, which aims at bringing transparency to high hospital bills and to tackle the question of “why these prices are such a problem for the American health care system.” […]

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Discrepancy Between Insurer And Hospital Leaves Consumer With A $24K Bill
2 years Ago

Discrepancy Between Insurer And Hospital Leaves Consumer With A $24K Bill

Photo by Heidi de Marco/KHN Three year-old Elodie Fowler went to Lucile Packard Children’s Hospital for an MRI. She has a rare genetic condition and her doctors wanted to have a better understanding of what was causing swelling in the right-side body and digestion issues, Vox reports. The scan only took about 30 minutes. When […]

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9-Month-Old With Brain Cancer Sent Denial Letter
2 years Ago

9-Month-Old With Brain Cancer Sent Denial Letter

9-month-old Connor Richardson is battling brain cancer and his insurance company. Recently, Connor and his parents received a letter informing them the insurer would not cover an experimental but necessary cancer treatment. According to The Daily Beast: Connor was only seven months old when he had an uncharacteristic bout of crying through the night. His […]

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Appalachia Residents Battle Lack Of Accessible Mental Health Care
2 years Ago

Appalachia Residents Battle Lack Of Accessible Mental Health Care

A new article from Kaiser Health News highlights the lack options for mental health treatment in Appalachia, and the measures many consumers and physicians take in order to meet the community’s need. In at least one county in West Virginia, there are no psychiatrists. The lack of available care options means that many individuals have […]

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Transgender Consumers In RI Encounter Barriers To Care
2 years Ago

Transgender Consumers In RI Encounter Barriers To Care

Transgender consumers in Rhode Island were recently polled on a range of issues by the National Center For Transgender Equality.  RI Future highlighted the survey’s findings, including issues with health care coverage and mental health.  The survey found that many respondents reported harassment, coverage denial, and distress because of their gender identity. According to RI […]

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New Executive Order Could Hurt Consumers
2 years Ago

New Executive Order Could Hurt Consumers

In the wake of the failed ACA repeal and replace, President Trump has signed an executive order on health care, which could have a negative impact on consumers. Former CMS Director Andy Slavitt has argued the move would eliminate protections for pre-existing condition protections and make the individual exchanges a high-risk pool. The White House […]

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Patient Groups Protest MA Waiver, Transportation Cuts
2 years Ago

Patient Groups Protest MA Waiver, Transportation Cuts

Numerous patient and advocacy groups have spoken out against Massachusetts’ proposed Medicaid waiver request, which would take away transportation benefits for many MassHealth beneficiaries. The waiver would eliminate transportation services for non-disabled adults in non-emergency situations, The Republican reports. Massachusetts claims the change would save $5 Million in 2020 – a small fraction of the […]

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Massachusetts’ Waiver Request Could Harm Consumers
2 years Ago

Massachusetts’ Waiver Request Could Harm Consumers

The Commonwealth of Massachusetts is asking the federal government to be allowed to make cuts to Medicaid, curtail access to long-term and in-home health care supports, and limit drug coverage.  According to Modern Healthcare: The state has asked for permission to move childless, non-disabled adults with incomes above the federal poverty level into subsidized commercial […]

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Study Finds Mental Health Coverage Narrower Than Other Coverage
2 years Ago

Study Finds Mental Health Coverage Narrower Than Other Coverage

Consumers who are looking to get mental health treatment while being insured by a narrow network plan may have a difficult time finding a doctor in their network. A new study published in Health Affairs has found disparities between coverage for mental health and medical/surgical coverage in narrow network plans. Kaiser Health News reports that […]

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Insurer Denies Man’s Painkillers After Back Surgery
2 years Ago

Insurer Denies Man’s Painkillers After Back Surgery

Joe Stanziano had recently undergone his fourth back surgery in five years, when his doctor prescribed an opioid to aid his recovery.  As recovery progressed, his doctor decided to start tapering off the pain meds by prescribing a lower dose. Stanziano’s insurer denied coverage of the medication. PAMED recently reported Stanziano’s experience to highlight the […]

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Observational Status Creates Roadblocks To Recovery For Medicare Patients
2 years Ago

Observational Status Creates Roadblocks To Recovery For Medicare Patients

Many senior citizens believe that their insurance would cover costs related to a fall or accident; but a hidden policy – called observational care – may jeopardize their care, Reader’s Digest reports. Elisa Roland chronicles the obstacles in getting her mother adequate care, after she suffered a fall and could not walk.  Before the accident, […]

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As Future Of ACA Remains In Flux, Top Insurers Make $6 Billion
2 years Ago

As Future Of ACA Remains In Flux, Top Insurers Make $6 Billion

As debate over the affordable care act continues many questions remain about the future of our health care system.  However, one thing is certain, America’s health insurance companies are doing very well: Combined, the nation’s top six health insurers reported $6 billion in adjusted profits for the second quarter. That’s up more about 29 percent […]

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Narrow Network Plans Offer Less Mental Health Coverage
2 years Ago

Narrow Network Plans Offer Less Mental Health Coverage

A recent study found that narrow-network plans offer even more limited mental health care, Reuters reports. Narrow-network plans were created to bring lower-cost health insurance plans to ACA markets. These plans generally limit coverage to fewer than 25 percent of providers in a given market. The study found that while narrow-network plans cover 24 percent […]

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Study Finds Most Emergency Room Visits Are Valid
2 years Ago

Study Finds Most Emergency Room Visits Are Valid

Consumers are almost always justified in visiting the emergency room despite recent cutbacks from insurers. A new study from the University of California at San Francisco has found that only 3.3 percent of ER visits are considered avoidable, Axios reports. The study found 3 major conclusions: The definition of “avoidable” is what splits most parties. […]

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VA Insurers Accused Of Disobeying Law Over Cancer Treatment
2 years Ago

VA Insurers Accused Of Disobeying Law Over Cancer Treatment

Photo by Heidi de Marco/KHN Despite state law, consumers in Virginia may have difficulty getting proton therapy, a treatment for cancer, covered. The parent company of Virginia’s only proton therapy center has issued a statement accusing insurers of violating a state law, which exists to give people access to the therapy, the Daily Press reports. […]

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Patients’ HIV Status Exposed By Aetna ‘Mistake’
2 years Ago

Patients’ HIV Status Exposed By Aetna ‘Mistake’

Aetna has come under fire after exposing some costumers’ HIV status.  The insurer sent letters to consumers, which contained information about changes in access to HIV medications. According to the Washington Post, the envelopes’ clear window made the contents of the letters visible without opening the mail. For some of these customers, a plastic window […]

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New Study Suggests Insurance Denials Could Be Making Patients Sicker
2 years Ago

New Study Suggests Insurance Denials Could Be Making Patients Sicker

A new study by the Doctors-Patient Rights Project (DPRP), found that over 50 million Americans are lacking access to health treatments, despite having insurance.  Specifically, the study looked at insurance denials and their long-term effects on patients.  According to the study, one third of patients who experienced insurance denials have had their health adversely effected […]

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Consumers In Indiana Hit By Anthem’s Emergency Room Coverage Cuts
2 years Ago

Consumers In Indiana Hit By Anthem’s Emergency Room Coverage Cuts

Indiana residents covered by Anthem will soon have to think twice before visiting the emergency room.  The insurer will notify customers that their ER visits might not be covered by their insurance, Fox 59 reports. Last week, Consumers For Quality Care sent a letter to the Indiana Insurance Commissioner that urged him to reject the […]

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DOJ and Mylan Reach EpiPen Settlement That Could Benefit Consumers
2 years Ago

DOJ and Mylan Reach EpiPen Settlement That Could Benefit Consumers

Almost a year after Mylan Pharmaceuticals was the subject of an outpouring of public disapproval; the Justice Department has reached a settlement with the company. The settlement includes reimbursements to Medicaid programs in every state, which will make the programs more solvent for consumers. Mylan was accused of overcharging the government for the emergency allergy […]

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Study: Poorer Patients May Be Hardest Hit By Observational Hospital Care
2 years Ago

Study: Poorer Patients May Be Hardest Hit By Observational Hospital Care

A new study published in the American Journal of Medicine suggests that poorer patients are spending more for hospital care.  While Medicare patients pay a fixed amount for inpatient treatment, the charges incurred when patients are not sick enough for inpatient care can be higher. Reuters reports: [P]eople who aren’t sick enough for an inpatient […]

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Consumers Get Left In The Dark On Pricing For New Hospital Procedures
2 years Ago

Consumers Get Left In The Dark On Pricing For New Hospital Procedures

Photo by Heidi de Marco/KHN Hospitals’ public announcements of their newest and most innovative surgeries, procedures and technologies are less than helpful to consumers, Axios reports. Hospitals will often issue press releases or mass e-mails announcing these services. These blasts can go on to be picked up by local news stations or other services. This past […]

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Patient Groups File Civil Rights Complaint Over Hemophilia Coverage
2 years Ago

Patient Groups File Civil Rights Complaint Over Hemophilia Coverage

Patients groups representing individuals with hemophilia have filed a civil rights complaint in Iowa that accuses health insurer Wellmark of engaging in discrimination, Washington Examiner reports. National Hemophilia Foundation, The Hemophilia Federation of America, and Hemophilia of Iowa allege that Wellmark exited the ACA market in Iowa to avoid paying for patients with hemophilia, including […]

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UnitedHealth Apologizes After Truvada Letter
2 years Ago

UnitedHealth Apologizes After Truvada Letter

An insurer is changing a company policy regarding Truvada, an HIV medication, after pushback from activists, NBC reports. UnitedHealth recently came under fire after a denial letter for the medication was circulated online.  In the rejection letter, the insurer cited the patient’s “high risk homosexual behavior” as its reason for the denial. The letter came […]

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Customer Told Insurance Would Not Cover His Surgery, Despite Pre-Approval And Payment
2 years Ago

Customer Told Insurance Would Not Cover His Surgery, Despite Pre-Approval And Payment

Chet Hartley, a retired law enforcement officer, was in for a shock when he received a letter from his insurer saying they would not cover his surgery, months after it had taken place.  KUTV explains, the letter said the surgery would not be covered, despite the fact that Hartley received pre-approval and had already paid […]

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Veteran Winning The Battle Against Congestive Heart Failure, Losing Battle With His Insurer For Required Care
2 years Ago

Veteran Winning The Battle Against Congestive Heart Failure, Losing Battle With His Insurer For Required Care

Matthew Nunley, a veteran, is facing the battle of his life. He has been diagnosed with congestive heart failure and is battling Anthem to cover the device keeping him alive, reports WDRB. Nunley’s diagnoses came in November 2016, after he got the flu. Doctors told Nunley it was a one-in-10,000 chance a virus would attack […]

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Tips for Consumers Hit By Surprise Medical Bills
2 years Ago

Tips for Consumers Hit By Surprise Medical Bills

As surprise medical bills continue to be a concern for consumers, more people are taking notice. A recent Yale study highlighted the growing phenomenon. Now, Huffington Post offers a first-person example of how to deal with the common issues that result in unexpectedly expensive hospital bills and discusses strategies for consumers to fight back. These […]

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Patients Face Surprise Coverage Gaps And Increasingly Shoulder The Burden Of Health Care Costs
2 years Ago

Patients Face Surprise Coverage Gaps And Increasingly Shoulder The Burden Of Health Care Costs

As health care costs continue to rise in the United States, patients are increasingly being stuck with a larger and larger portion of the bill. According to the Kaiser Family Foundation, the average deductible among covered workers with a deductible has gone up nearly $1,000 in just ten years: Writing in The Huffington Post, Dr. […]

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New Study Highlights Problem Of Surprise Medical Bills For Consumers
2 years Ago

New Study Highlights Problem Of Surprise Medical Bills For Consumers

In another chapter of an ongoing trend, consumers across the country have been facing steep medical bills after hospital visits they thought were in their insurance network. One California woman, Debra Brown, was shocked to get $500 out-of-network hospital bill from a doctor who she said never identified himself and only briefly touched her injured […]

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Narrow Networks Can Mean Less Access To Cancer Experts
2 years Ago

Narrow Networks Can Mean Less Access To Cancer Experts

Customers that have narrow network health plans probably can’t see top cancer experts. According to HealthDay: Less-expensive “narrow network” health plans are much less likely to cover treatment by doctors at centers affiliated with the U.S. National Cancer Institute, said study lead author Laura Yasaitis. The information comes from a recent study by the University […]

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Woman Wakes Up From Minor Surgery To Find Her Front Teeth Knocked Out
2 years Ago

Woman Wakes Up From Minor Surgery To Find Her Front Teeth Knocked Out

Gail Tapp, woke up from a minor surgery at Forth Worth’s USMD Hospital to find that her front teeth had been knocked out, CBS DFW reports. Tapp said doctors at USMD Hospital in Fort Worth told her husband they had accidentally knocked out three teeth while removing her breathing tube after routine bladder surgery. The […]

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Consumers Sue After Being Denied Mental Health And Drug Treatments
2 years Ago

Consumers Sue After Being Denied Mental Health And Drug Treatments

Blue Shield of California is facing a class-action lawsuit that claims the insurer improperly denied outpatient and residential care for patients, Kaiser Health News reports. The suit was filed on behalf of two parents who say their children were denied coverage to treatment for mental health and substance abuse issues. The suit also claims that […]

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Woman Thought Her Surgery Was Preapproved, It Wasn’t
2 years Ago

Woman Thought Her Surgery Was Preapproved, It Wasn’t

A Utah insurance company, Select Health, has come under scrutiny for refusing to pay for a surgery after preapproving the procedure, KUTV reports. Kristine LaMay submitted a pre-approval for her knee-replacement surgery. After she gained approval from her insurance company, she received the surgery. Now, the insurance company is saying it won’t pay. [N]early a […]

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Patients Struggle To Get Powerful, Life-Changing Cholesterol Medicine
2 years Ago

Patients Struggle To Get Powerful, Life-Changing Cholesterol Medicine

Patients who need cholesterol drugs are having a very difficult time getting them. The Wall Street Journal reports: Some doctors believe PCSK9 inhibitors could be a lifesaving solution for millions of heart-disease patients and could transform treatment for the most difficult cases—patients with FH, as well as those with a history of heart disease or […]

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Consumer Group Skips CT Rate Request Hearing It Deems Futile
2 years Ago

Consumer Group Skips CT Rate Request Hearing It Deems Futile

Photo by Heidi de Marco A prominent consumer advocacy organization in Connecticut elected to skip public health insurance rate request hearings hosted by the state Insurance Department. The Universal Health Care Foundation of Connecticut explained their non-attendance was intended as a protest to the timing and format of the meetings. The group complained the meetings […]

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Minnesota Woman Battles Insurer For Access To Life-Saving Medicine
2 years Ago

Minnesota Woman Battles Insurer For Access To Life-Saving Medicine

Minneapolis’ City Pages recently reported one woman’s battle to get her medication covered by her insurer, Blue Cross Blue Shield of Minnesota. The experience, she says, leaves her furious. I am furious. Furious that my insurance company preferred to pass me between divisions, departments, and parent companies rather than take responsibility for dealing with my […]

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Aetna Denies Alaska Woman Life-Saving Surgery
2 years Ago

Aetna Denies Alaska Woman Life-Saving Surgery

Photo by Heidi de Marco An Alaska woman is battling her insurance company to receive a life-saving surgery, the Alaska Dispatch News details. Barbara Ross, who supports a family of ten, has a hereditary lymphedema, which causes her body to retain fluid under the skin. After an injury, her condition worsened. She lost the ability […]

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Georgia Insurance Department Monitoring New BCBS ER Rules
2 years Ago

Georgia Insurance Department Monitoring New BCBS ER Rules

Georgia’s Insurance Department announced it would monitor a new Blue Cross Blue Shield policy that seeks to limit coverage for certain types of emergency room visits. According to Georgia Health News: The state insurance department says it will monitor the new emergency room policy of Blue Cross and Blue Shield of Georgia “to make sure […]

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Consumers Get Short Shrift As Insurers See Huge Income
2 years Ago

Consumers Get Short Shrift As Insurers See Huge Income

For consumers, there seems to be an ever-expanding list of negative headlines. Consumers have seen big premium increases on the ACA exchanges. Networks have narrowed leaving families and individuals with little choice in their health care. Services that some consumers have taken for granted, like heading to the Emergency Room in case of an emergency, […]

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Are Consumers Being Denied Mental Health Coverage?
2 years Ago

Are Consumers Being Denied Mental Health Coverage?

Photo by Heidi de Marco/KHN The Boston Globe recently reported on a growing trend of insurance companies refusing to cover mental health programs. Wilderness Therapy, a form of behavioral therapy, is increasingly accepted by mental health professionals to treat behavioral, substance abuse and mental health issues in teenagers. The programs use many of the same tactics […]

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What Happens When An Insurer Denies Important Medication?
2 years Ago

What Happens When An Insurer Denies Important Medication?

A new report from CNN highlights a young man’s story of being denied a life-saving medicine by his insurance company. He filed a lawsuit in 2015 and the suit’s trial is set for this summer. In November 2014, Gillen Washington, a Northern Arizona University student, went into his clinic. It should have been a routine […]

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Consumers In Georgia, Missouri, And Kentucky May Get Surprise Emergency Room Bills
2 years Ago

Consumers In Georgia, Missouri, And Kentucky May Get Surprise Emergency Room Bills

Anthem Blue Cross Blue Shield sent letters to customers in three states that warned some emergency room visits wouldn’t be covered. In Georgia, Missouri, and Kentucky, plans will no longer pay for visits that Anthem deems are no longer necessary. Emergency room physicians are upset about the letters. Dr. Becky Parker, president of the American […]

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Surprise Medical Bills In New Jersey Are Another Chapter In A Growing Trend
2 years Ago

Surprise Medical Bills In New Jersey Are Another Chapter In A Growing Trend

A recent investigative article from the New Jersey Star-Ledger details one woman’s struggle with a growing trend: unexpected, out-of-network hospital billings. Margo Anderson of New Jersey had a medical emergency and took care to go to a hospital that was considered “Tier 1” for her health plan. In other words, she went to a hospital […]

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Uninsured, Minorities Face Highest Emergency Room Bills
2 years Ago

Uninsured, Minorities Face Highest Emergency Room Bills

A new study from the Journal of the American Medical Association found that uninsured individuals and minority groups are often the highest billed emergency room patients. As Vox reports:   Welcome to the arcane and arbitrary world of billing practices at US hospitals today, as detailed in a new JAMA Internal Medicine study. The researchers, […]

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BCBS Illinois Faces State Review For First Time In Decades
2 years Ago

BCBS Illinois Faces State Review For First Time In Decades

The state of Illinois is conducting a “market conduct exam” of Blue Cross Blue Shield for the first time in 27 years. The reviews examine how insurers pay claims and handle customer complaints among other things. According to the Chicago Tribune:   Blue Cross and Blue Shield of Illinois confirmed the review this week, in […]

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BCBSNC Asks Consumers To Pay More After Announcing Big Profits And Million Dollar Bonuses
2 years Ago

BCBSNC Asks Consumers To Pay More After Announcing Big Profits And Million Dollar Bonuses

Last month, Blue Cross Blue Shield of North Carolina filed a request to raise premiums by 23 percent in 2018. Its customers have faced double digit increases for years:   “Steep rate increases have been a consistent feature of Blue Cross’s ACA coverage in North Carolina, and Thursday’s announcement follows a 24.3 percent rate increase […]

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