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Pharmacy benefit managers have curtailed in-person audits of pharmacy claims during the pandemic, switching to virtual audits done by computer. That has markedly increased the number of claims they can review ā and the chances for payment denials ā squeezing pharmacies and bringing in more cash for the benefit companies.
In an ongoing effort to control prescription drug costs, states are targeting the companies that mediate deals among drug manufacturers, health insurers and pharmacies. The pharmacy benefit managers say they negotiate lower prices for patients, yet the nitty-gritty occurs largely behind a curtain that lawmakers are trying to pull back.
Pandemic lockdowns exacerbated long-standing economic pressures on pharmacies ā and forced many owner-operated shops to evolve or risk closing their doors.
With schools opening up classrooms, millions of young athletes are also getting out on fields and courts. But pandemic precautions and delays are spurring conflicts among parents, coaches and doctors.
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Hereās a collection of their appearances.
During the pandemic, shelters are having to change the way they do things to prevent the virus from spreading among the vulnerable homeless population. Now, as winter weather moves in, thereās less room at the shelters for those in need ā threatening to leave many, literally, out in the cold.
Furious over Republicansā handling of the pandemic, Wisconsin health care workers are speaking out against the president ā and running for office.
A survey of 17 cities found more than 50,000 pandemic-related eviction filings. Housing advocates worry that increased housing instability will lead to more COVID-19 and other illnesses.
A KHN review found more than 20 states either donāt count or have incomplete data on the use of COVID-19 antigen tests, leaving the public in the dark about the true scope of the pandemic.
Once there were 23 of these nonprofit plans across 26 states; in January there will be only three, serving Maine, Wisconsin, Montana, Idaho and Wyoming.
Many states are dramatically loosening regulations on nurse practitioners as the coronavirus pandemic increases demand for health care workers. But not California.
Wisconsin hospitals had filed at least 104 lawsuits in small claims court since the state declared a public health emergency March 12. Most now say they are suspending the cases; one hospital has dismissed them after a reporterās calls.
For rural physicians, the burden of responding to the opioid epidemic falls squarely on their already loaded shoulders. For one doctor in a small Wisconsin village, there was no question that she wanted to rise to the challenge.
Without the teamwork, communication and quick action of several veteran health officials in Wisconsin, the world might not know about the vaping illness the U.S. is battling today. This is their story.
Some Veterans Affairs hospitals around the country use writers to record patients' life stories, then place a short biography in each vetās medical record. The My Life, My Story program gives clinicians another way to get to know their patients.
In this episode of KHNās āWhat the Health?ā Julie Rovner of Kaiser Health News, Margot Sanger-Katz of The New York Times, Anna Edney of Bloomberg News and Joanne Kenen of Politico discuss the start of open enrollment for individual health insurance plans for 2019 and preview what next weekās midterm elections might mean for health policy. Plus, Barbara Feder Ostrov of KHN and California Healthline talks to Julie about the latest NPR-KHN āBill of the Monthā feature.
The Group Insurance Board reversed a decision made last year to bar coverage of transgender hormone therapy and surgery for public workers.
Dramatic policy swings, from an unprecedented expansion of transgender rights under the Obama administration to the unpredictable reduction of trans rights under President Donald Trump, have left many trans Americans feeling the whiplash.
Moly-99, as itās called, is created in just six government-owned nuclear research reactors ā none in North America ā raising concerns about the reliability of the supply.
The Trump administration is poised to grant states waivers that some critics say could change the shape of the program.
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