Fighting a Health Insurance Denial? Here Are 7 Tips To Help
Many people don鈥檛 know they can fight a health insurance denial, let alone how to do it. Here are practical tips for consumers who want to appeal a prior authorization decision.
North Carolina
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As Insurers Struggle With GLP-1 Drug Costs, Some Seek To Wean Patients Off
Conventional wisdom says GLP-1 drugs must be taken indefinitely to maintain weight loss. But a growing number of researchers, payers, and providers are challenging that consensus and exploring whether 鈥 and how 鈥 to taper patients off expensive GLP-1 drugs.
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Do Pediatricians Recommend Vaccines To Make a Profit? There鈥檚 Not Much Money in It
Four pediatricians said evidence-based science and medicine and a desire to keep kids healthy drive doctors鈥 childhood vaccination recommendations. And while pediatric practices might make money immunizing privately insured children, most practices likely break even or lose money from providing the shots.
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When Hospitals and Insurers Fight, Patients Get Caught in the Middle
About 90,000 people spent months in limbo as central Missouri鈥檚 major, and often only, provider fought over insurance contracts. Patients getting caught in the crossfire of disputes has become a familiar complication, as about 8% of hospitals have left an insurer network since 2021. Trump administration policies could accelerate the trend.
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The National Suicide Hotline For LGBTQ+ Youth Shut Down. States Are Scrambling To Help.
LGBTQ+ youth lost dedicated support on the 988 Suicide & Crisis Lifeline in July at a critical time. Advocates say mental health issues are rising in that population amid hostility from the Trump administration.
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New Medicaid Federal Work Requirements Mean Less Leeway for States
More than a dozen states are seeking their own versions of Medicaid work requirements. But the incoming federal standards pose questions around how much leeway states have to design their rules.
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Tribal Groups Assert Sovereignty as Feds Crack Down on Gender-Affirming Care
Native American groups declare that tribal sovereignty trumps state and federal efforts to restrict or ban gender-affirming care for two-spirit and LGBTQ+ tribal citizens. Tribes are analyzing the risk of opposing Trump鈥檚 policies, advocates say.
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Los Angeles Weighs a Disaster Registry. Disability Advocates Warn Against False Assurances.
Amid increasingly frequent natural disasters, several states have turned to registries to prioritize help for vulnerable residents. But while some politicians see these registries as a potential solution to a public health problem, many disability advocates say they endanger residents with mobility problems by giving a false sense of security.
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Who鈥檚 Policing Opioid Settlement Spending? A Crowdsourced Database Might Help
Billions in opioid settlement money was meant to be spent on treating and preventing addiction 鈥 but what happens if it鈥檚 misspent? Some advocates say attorneys general need to pay closer attention. If they don鈥檛, a new tool might empower the public.
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Watch: She鈥檚 at High Risk of Breast Cancer. She Moved, and Her Screening Costs Soared.
This installment of InvestigateTV and 吃瓜不打烊鈥 鈥淐ostly Care鈥 series explores how the type of medical facility where a patient seeks care can affect the cost of that care 鈥 particularly when that facility is a hospital.
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GOP Governors Mum as Congress Moves To Slash Medicaid Spending for Their States
In 2017, when President Donald Trump tried to repeal Obamacare and roll back Medicaid coverage, Republican governors helped turn Congress against it. Now, as Trump tries again to scale back Medicaid, Republican governors 鈥 whose constituents stand to lose federal funding and health coverage 鈥 have gone quiet on the health consequences.
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Kennedy鈥檚 Vaccine Advisers Sow Doubts as Scientists Protest US Pivot on Shots
A new vaccine advisory panel appointed by the HHS secretary, a longtime anti-vaccine activist, reflected his unsupported claims about the safety of childhood inoculations.
By Arthur Allen and Sam Whitehead -
鈥楴ot Accountable to Anyone鈥: As Insurers Issue Denials, Some Patients Run Out of Options
Health insurers issue millions of prior authorization denials every year, leaving many patients stuck in a convoluted appeals process, with little hope of meaningful policy change ahead. For doctors, these denials are frustrating and time-consuming. For patients, they can be devastating.
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鈥極ne Big Beautiful Bill鈥 Would Batter Rural Hospital Finances, Researchers Say
Rural hospitals would take an outsize hit from Republicans鈥 proposed cuts to Medicaid and other federal health programs. Researchers say the financial erosion would trigger hospital closures and service cuts, especially in communities where large shares of patients are enrolled in Medicaid.
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Trump Won鈥檛 Force Medicaid To Cover GLP-1s for Obesity. A Few States Are Doing It Anyway.
Late last year, South Carolina Medicaid approved a class of medications known as GLP-1s to treat obesity, placing it among the few state programs covering these effective but expensive drugs. But access remains limited, even for patients covered by Medicaid, because of stringent prerequisites that must be satisfied before starting the drug.
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Housing, Nutrition in Peril as Trump Pulls Back Medicaid Social Services
About half of states have broadened Medicaid, the state-federal low-income health care program, to pay for social services such as housing and nutritional support. The Trump administration, however, views these experiments as distractions from the core mission to provide health care.
By Angela Hart -
Pain Clinic CEO Faced 20 Years for Making Patients ‘Human Pin Cushions.’ He Got 18 Months.
Michael Kestner, CEO of Pain MD, was convicted of 13 fraud felonies after his company gave patients hundreds of thousands of questionable injections at clinics in Tennessee, Virginia, and North Carolina.
By Brett Kelman -
Seeking Spending Cuts, GOP Lawmakers Target a Tax Hospitals Love To Pay
Republicans, on the hunt for spending cuts, are eyeing a special kind of Medicaid tax that nearly every state uses to boost funding for hospitals, nursing homes, and other providers.
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As a Diversity Grant Dies, Young Scientists Fear It Will Haunt Their Careers
The Trump administration defunded the National Institutes of Health鈥檚 MOSAIC grant program, which launched the careers of scientists from diverse backgrounds.
By Brett Kelman -
Beyond Ivy League, RFK Jr.鈥檚 NIH Slashed Science Funding Across States That Backed Trump
A 吃瓜不打烊 analysis underscores how the terminations have spared no part of the country, politically or geographically. Of the organizations that had grants cut in the first month, about 40% are in states President Donald Trump won in November.
By Rae Ellen Bichell and Rachana Pradhan