Preventive Care May Be Free, but Follow-Up Diagnostic Tests Can Bring Big Bills

When Cynthia Johnson learned she would owe $200 out-of-pocket for a diagnostic mammogram in Houston, she almost put off getting the test that told her she had breast cancer.

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Can California Keep Offering Cheap Health Care? Here’s What State Network’s New CEO Says

Jessica Altman took over in March as chief executive officer of Covered California, and even as she was settling into a new home in Sacramento she also was making the rounds with congressional leaders to drive home just how much Californians want access to health insurance. The greatest barrier to getting it is all too ...

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American Hospital Association Urges CMS To Extend Enforcement Discretion For No Surprises Act

The American Hospital Association has urged the Centers for Medicare and Medicaid Services to extend enforcement discretion for the No Surprises Act regulatory requirement that healthcare providers exchange certain information to create a good faith estimate for uninsured and self-pay patients – until the agency identifies, and providers can implement, a standard, automated way to exchange the ...

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After Months Of Warnings, CMS Hands Out Its First Fines To Hospitals Failing On Price Transparency

Eighteen months after its final rule on price transparency went into effect, the Centers for Medicare and Medicaid Services issued its first penalties to a pair of Georgia hospitals that did not update their websites or reply to the agency’s warning letters. Northside Hospital Atlanta and Northside Hospital Cherokee have been issued civil monetary penalties ...

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Survey: 13% Of Medicare Advantage Claims, Prior Authorization Requests Denied

A recent survey of Medicare Advantage enrollees found 13% had a claim or pre-authorization request denied as the program has gotten scrutiny over its prior authorization practices. The survey, released Monday by the online insurance marketplace eHealth, also found that 67% of respondents chose MA over Medigap due to concerns over its affordability. The MA ...

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COVID Hospitalizations Grow, But Drop In Cases May Be Misleading

COVID-19 hospitalizations continue to inch up in Clark County and in Nevada, even as one metric shows confirmed cases dipping, though officials caution that the growing use of at-home tests is leading to undercounts.

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