While prior authorization was traditionally required only for expensive, elective or new procedures, such as a hip replacement or bypass surgery, some insurers now require it for even the renewal of some prescription drugs. Those preapprovals are frequently time-limited.
While doctors and hospitals chafe at the administrative burden, insurers contend the review is necessary to ferret out waste in a system whose costs are exploding and to ensure physicians are prescribing useful treatments. But patients face an even bigger problem: When insurers revoke their decision to pay after the service is completed, patients are legally on the hook for the bill.
Insurers Are Bankrupting Patients by Charging Unexpectedly for Preapproved Care
truthout.org
When insurers revoke their decision to pay after a service is completed, patients are legally on the hook for the bill.Sure isn’t surprising
Illinois became one of the first states in the U.S. to limit the out-of-pocket price of insulin when Gov. J.B. Pritzker signed a measure on Friday that caps the cost of medication people with diabetes rely on.
Sen. Andy Manar, the downstate Democrat who sponsored the bill that caps the out-of-pocket cost for insulin at $100 for a 30-day supply regardless of how much is needed to fill a patient’s prescription, called it the “biggest step that we can take under Illinois law.” The law takes effect Jan. 1.
Saying ‘diabetes doesn’t discriminate,’ Gov. J.B. Pritzker signs measure limiting out-of-pocket cost of insulin to $100 for 30-day supply
www.chicagotribune.com
Illinois became one of the first states in the U.S. to limit the out-of-pocket price of insulin when Gov. J.B. Pritzker signed a measure on Friday that caps the cost of medication people with diabetes...Most major Democratic presidential hopefuls have proposed new government assistance for those receiving long-term supports and services and their families. Mayor Pete Buttigieg has proposed public catastrophic long-term care insurance. Senators Elizabeth Warren and Bernie Sanders would make home-based care a Medicare for All benefit. And former vice president Joe Biden and Sen. Amy Klobuchar would create new tax credits for long-term care.
But tax credits may not be the most effective way for government to provide this support. They can be difficult to administer and, as designed, likely these would benefit relatively few of those who most need assistance.
Are Tax Credits The Best Way To Subsidize Long-Term Care Costs?
www.taxpolicycenter.org
Most major Democratic presidential hopefuls have proposed new government assistance for those receiving long-term supports and services and their families. Mayor Pete Buttigieg has proposed...Total deaths from suicide, alcohol, or drugs, what some call “deaths of despair,” increased by 51 percent from 2005 to 2016 in the United States, and drug overdose deaths increased by 16 percent per year between 2014 and 2017. These statistics reflect the well-documented opioid crisis and what some experts have called a national “mental health crisis.”
The Affordable Care Act (ACA) and related benefit parity requirements led to important strides in expanding behavioral health care coverage, but the law has not yet achieved its potential to advance full access to—and timely use of—behavioral health services.
Battling The Mental Health Crisis Among The Underserved Through State Medicaid Reforms | Health Affairs
www.healthaffairs.org
Health Affairs Blog Related Topics: Behavioral health care Medicaid Access to care Affordable Care Act Payment Primary care Mental health Pharmaceuticals Uninsured Medicaid coverage Battling The Menta...