KHN's Health Costs News: March 31, 2022

This month, KHN covered the Bill of the Month, a proposed $35 cap on insulin, doctor shortages, therapy delays, and more.

Not rendering correctly? View this email as a web page here. Not a subscriber? Sign up   Health Care Costs Thursday, March 31, 2022                       Visit KHN for the latest headlines BILL OF THE MONTH  The Case of the $489,000 Air Ambulance Ride   (MADDY ALEWEIN FOR KHN) By Julie Appleby Sean Deines and his wife, Rebekah, were road-tripping after he lost his job as a bartender when the pandemic hit. But while visiting his grandfather in a remote part of Wyoming, Sean started to feel very ill. Rebekah insisted he go to an urgent care center in Laramie. "'Your white blood count is through the roof. You need to get to an ER right now,'" Deines, 32, recalls a staffer saying. The North Carolina couple initially drove to a hospital in Casper but were quickly airlifted to the University of Colorado Hospital near Denver, where he was admitted on Nov. 28, 2020. There, specialists confirmed his diagnosis: acute lymphoblastic leukemia, a fast-growing blood cancer. "Literally within 12 hours, I needed to figure out what to do with the next step of my life," said Deines. So, after he was started on intravenous treatments, including steroids and antibiotics, in Colorado to stabilize him, the couple decided it was prudent to return to North Carolina, where they could get help from his mother and mother-in-law. They selected Duke University Medical Center in Durham, which was in his insurance network. His family called Angel MedFlight, part of Aviation West Charters of Scottsdale, Arizona, which told Rebekah Deines that it would accept whatever the couple's insurer would pay and that they would not be held responsible for any remaining balance. Sean Deines was flown to North Carolina on Dec. 1, 2020, and taken by ground ambulance to Duke, where he spent the next 28 days as an inpatient. By his discharge, he felt better and things were looking up. Then the bills came. Read more here.  ••• Surprise Bills and Medical Debt  How to Avoid Surprise Bills — And the Pitfalls in the New Law By Dan Weissmann The No Surprises Act offers protection from many surprise medical bills — but that protection may be only as good as a patient's knowledge of the law and ability to make sure it's enforced. Here's what you need to know. 'An Arm and a Leg': A Fight for the Right to Help By Dan Weissmann It's illegal for a person who isn't a lawyer to give even basic legal advice to people being sued for medical debt. Two New Yorkers are suing to change that. ••• Medicare Medicare Advantage Plans Send Pals to Seniors' Homes for Companionship — And Profits By Phil Galewitz Many Medicare Advantage plans send caregivers to the homes of seniors periodically to help with housework and provide companionship. But the workers may also prod seniors into activities that boost the plans' Medicare ratings and federal reimbursements. ••• Drug Costs $35 Insulin Cap Is Welcome, Popular, and Bipartisan. But Congress May Not Pass It Anyway. By Michael McAuliff Spun off from the ailing but not-quite-dead Build Back Better legislation, a popular proposal to cap out-of-pocket insulin costs at $35 a month faces tough political realities that could kill it. Patients Divided Over Alzheimer's Drug: Is It a 'Risk I'm Willing to Take' or Just a 'Magic Pill'? By Judith Graham Medicare has proposed limiting coverage of Aduhelm, the costly new drug to treat Alzheimer's disease, and several prominent groups representing patients and their families are pressing the program to make it more widely available. But among individuals facing the disease, the outlook is more nuanced. 'An Arm and a Leg': Need an Expensive Drug? Here's What You Need to Know By Dan Weissmann Even a personal finance expert can get stuck with a huge unexpected bill for a drug. Listen up for what you need to know about "copay accumulators." ••• Health Care Industry Missouri Tried to Fix Its Doctor Shortage. Now the Fix May Need Fixing. By Bram Sable-Smith Five states have created "assistant physician" licenses that allow medical school graduates to practice without completing residency training. But a federal indictment in Missouri of one assistant physician has some original supporters trying to rein in the medical specialty. Delays for Autism Diagnosis and Treatment Grew Even Longer During the Pandemic By Andy Miller and Jenny Gold Despite increased public awareness, research advances, and wider insurance coverage for autism therapies, children often wait months — in some cases more than a year — to get an autism diagnosis and begin intervention services. The waits can be longer for Black and Latino children, and families in rural areas are also disadvantaged, without access to providers. Tennessee Offers to Expand Dental Schools as Medicaid Coverage Stretches Need By Blake Farmer, Nashville Public Radio As states expand Medicaid's dental benefits, they're running up against a shortage of dentists willing to work on those patients, especially in rural communities. So Tennessee is helping dental schools expand and offering to pay off student loans for those who work in high-need areas. ••• California Want Vulnerable Californians to Have Healthier Pregnancies? Doulas Say the State Must Pay Up. By Rachel Bluth California was supposed to start paying doulas this year to help Medicaid enrollees have healthy pregnancies. But the benefit has been delayed because doulas feel lowballed by the state's proposed reimbursement rate, which is below what most other states pay. California Governor's Big Promises on Drug Prices Are Slow to Materialize By Angela Hart and Rachel Bluth and Samantha Young Gov. Gavin Newsom has launched several initiatives to cut rising drug prices, but the savings haven't been as monumental as he promised. And his plan to have California make its own generic drugs hasn't gotten off the ground. Listen: An Unsettling Investigation Into the Closure of a Chain of Pain Clinics KHN senior correspondents Jenny Gold and Anna Maria Barry-Jester joined KVPR's Kathleen Schock on "Valley Edition" to discuss their investigation into the abrupt closure of one of California's largest chain of pain clinics — and the patients left behind.  ••• From Our Readers Readers and Tweeters Remain Vigilant on Masking and Billing By Terry Byrne KHN gives readers a chance to comment on a recent batch of stories. ••• Noticias En Español Noticias en español es una sección de Kaiser Health News que contiene traducciones de artículos de gran interés para la comunidad hispanohablante, y contenido original enfocado en la población hispana que vive en los Estados Unidos.   Cómo evitar facturas médicas sorpresa… y las "trampas" de la nueva ley By Dan Weissmann Aunque una ley supuestamente protege a los pacientes de las cuentas sorpresa, también tiene grietas por donde pasa la trampa. KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation. (c) 2022 Kaiser Family Foundation. All rights reserved. Follow us on Twitter | Facebook | LinkedIn You are subscribed to this email alert as albarkahslamet.ssss@blogger.com. Update your email preferences to choose the types of emails you receive. Or, permanently unsubscribe from all emails. If you need help or have questions, please send an email to subscriptions@kaiserhealthnews.org Please do not reply to this email as this address is not monitored.   KFF & KHN | 185 Berry Street | San Francisco, CA 94107