All posts tagged "Insurance"

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Reporting Highlights

• Payments Denied: After a North Carolina man attempted suicide twice, his wife sought coverage for his mental health treatment. His insurance carrier refused to pay for his care.
• Third-Party Reviews: Patients can appeal denials and even ask for additional review by independent physicians. But less than 1 in 10,000 patients eligible for those reviews seek them.
• Medical Necessity: Decisions made by those independent reviewers often turn on the issue of “medical necessity.” Reviewers’ decisions are binding and insurers must abide by them.

The email took Dr. Neal Goldenberg by surprise in a way that few things still do.

As a psychiatrist, he had grown accustomed to seeing patients in their darkest moments. As someone who reviewed insurance denials, he was also well-versed in the arguments that hospitals make to try to overturn an insurer’s decision not to pay for treatment....

Washington (AFP) - The popularity of remote work in the United States has emptied office buildings, a cause for worry as their value falls and owners risk losses on property loans -- in turn putting pressure on smaller banks. "There will be bank failures, but this is not the big banks," said US Federal Reserve Chair Jerome Powell on Thursday. In San Francisco, Washington and even New York, offices have been seeing half the number of people as before the pandemic, with white-collar workers reluctant to return to commuting. Office vacancy rates across the country have risen to 13.5 percent in 20......

On the presidential campaign trail, former President Donald Trump is, once again, promising to repeal and replace the Affordable Care Act — a nebulous goal that became one of his administration’s splashiest policy failures. “We’re going to fight for much better health care than Obamacare. Obamacare is a catastrophe,” Trump said at a campaign stop in Iowa on Jan. 6. The perplexing revival of one of Trump’s most politically damaging crusades comes at a time when the Obama-era health law is even more popular and widely used than it was in 2017, when Trump and congressional Republicans proved unab......

A growing number of states are opening taxpayer-funded health insurance programs to immigrants, including those living in the U.S. without authorization, even as Republicans assail President Joe Biden over a dramatic increase in illegal crossings of the southern border. Eleven states and Washington, D.C., together provide full health insurance coverage to more than 1 million low-income immigrants regardless of their legal status, according to state data compiled by KFF Health News. Most aren’t authorized to live in the U.S., state officials say. Enrollment in these programs could nearly double......

In September 2022, Elyse Greenblatt of Queens returned home from a trip to Rwanda with a rather unwelcome-back gift: persistent congestion. She felt a pain in her sinuses and sought a quick resolution. Covid-19 couldn’t be ruled out, so rather than risk passing on an unknown infection to others in a waiting room, the New Yorker booked a telehealth visit through her usual health system, Mount Sinai — a perennial on best-hospitals lists. That proved an expensive decision. She remembers the visit as taking barely any time. The doctor decided it was likely a sinus infection, not covid, and prescri......

Milagro, a Peruvian immigrant in Riverside County, California, has had spotty access to health care in the two decades she’s been in this country. The 48-year-old, who works as the office manager at a nonprofit, can get emergency care through a narrow set of benefits the state makes available to immigrants without legal residency. And she has been able to get mammograms, X-rays, and blood tests at clinics that charge according to income. But it can take a long time to get such appointments, and they are often far from home. “It’s very frustrating, because you have to have the time to go, and y......