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Examining Prior Authorization in Health Insurance

This post explains what’s known about how insurers use prior authorization as a tool to control costs and encourage cost-effective care, the state and federal laws that govern it, and ongoing policy debates over efforts to impose standards to limit or regulate its use.

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No Surprises Act Quiz

A new federal law provides new consumer protections against “surprise” medical bills beginning this year. Test your knowledge about its provisions with this 12-question quiz.

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Network Adequacy Standards and Enforcement

Health plan networks affect patient access to care. This brief reviews options for setting and enforcing network adequacy standards and tools for making differences in plan networks more transparent.

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How are Large Private Insurers Covering At-Home Rapid Tests?

Less than a week after a new federal mandate to cover such products took effect, about half of the nation’s largest private insurers allow enrollees to directly obtain rapid at-home COVID-19 tests from specific sources without having to pay anything upfront, a new KFF analysis finds. The new coverage requirement…

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How Are Private Insurers Covering At-Home Rapid COVID Tests?

This policy watch provides an early look at how top private insurers are implementing a new requirement to cover the cost of at-home COVID-19 tests. Initially about half offer a direct coverage option and half require an enrollee to pay upfront and then seek reimbursement.

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Medicaid and At-Home COVID-19 Tests

As COVID cases have surged across the United States due to the new Omicron variant, the Biden Administration has stepped up efforts to expand testing capacity including by making at-home COVID tests more available.

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‘In Focus with KFF’: What to Know About the New Ban on Surprise Bills

In this new video, KFF Senior Fellow Karen Pollitz explains why surprise bills have been such a major problem for patients, the new federal ban on the practice, and how patients can get help if they received a surprise bill.

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No Surprises Act Implementation: What to Expect in 2022

The “No Surprises Act,” which establishes new federal protections against most surprise out-of-network medical bills when a patient receives out-of-network services during an emergency visit or from a provider at an in-network hospital without advance notice, will take effect next month. A new KFF brief outlines what to expect in 2022.

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Poll: Few are Aware of Hospital Price Transparency Requirements

Few Americans realize that starting this year hospitals are required to post prices of common health services on their websites in a format patients can access and use, data from the KFF Health Tracking poll shows. Federal regulations that took effect January 1 require this price transparency for hospitals to…

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Few Adults Are Aware of Hospital Price Transparency Requirements

This data note for the Peterson-KFF Health System Tracker shows that few Americans realize that starting this year hospitals are required to post prices of common health services on their websites in a format patients can access and use.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.