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This summarizes key provisions of the No Surprises Act, enacted in December 2020 to address the problem of unexpected medical bills, and issues that could arise during implementation ahead of its Jan. 1, 2022 effective date.
A new Peterson-KFF analysis examines the potential impact of new federal price transparency rules on patient decision-making and market pricing for health services. The brief also includes new analysis of geographic variation in health prices.
This conference report summarizes discussions at a March 2018 conference in Washington with 30 leaders from the health care community to launch Initiative 18/11, a partnership between the Society of Actuaries and KFF to address the rising cost of health care in the United States. It also lays out the next steps for the initiative.
Recent legislation would require drug companies to pay rebates to the federal government when annual increases in prescription drug prices for Medicare and private insurance exceed the rate of inflation. As context for understanding the possible impact of this proposal, this analysis compares price changes for drugs covered by Medicare Part B (administered by physicians) and Part D (retail prescription drugs) between 2019 and 2020 to the inflation rate over the same period.
This data note explores findings from on an 8-day online search for at home COVID-19 tests at major retailers. The findings are described against the backdrop of the Biden Administration policy requiring plans to cover the cost of these tests. We find that these tests remain hard to find and that this limited availability could negatively affect the success of the reimbursement strategy.
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.
As the Build Back Better Act shifts from the House to the Senate, there’s considerable interest in provisions that would lower the cost of prescription drugs.
Attention to high list prices continues at both the state and federal levels with a number of policy proposals aimed at lowering drug prices and there is renewed interest in drug prices and reimbursement within Medicaid. Changes made in 2016 to federal rules governing how state Medicaid programs pay for drugs aimed to make the prices paid more accurate, but increased reliance on pharmacy benefit managers (PBMs) pose challenges to drug price transparency. This brief explains Medicaid prescription drug prices to help policymakers and others understand Medicaid’s role in drug pricing and any potential consequences of policy changes for the program.
This analysis examines list prices for COVID-19 testing at the largest hospitals in every state and finds they range widely from $20 to $850. Federal law now requires private insurers to cover COVID-19 tests at no cost to the patient and provides funding for people without health insurance.
Mergers and acquisitions involving hospitals and other health care providers are drawing attention from federal and state regulators, including the Federal Trade Commission, and policymakers amid concerns that such consolidations can reduce competition and contribute to the high costs of health care.
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