Category Archives: Right to know

Access – or lack of access – to health information is making news

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

key-in-lock-showing-forbidden-information-graphicstockSeveral stories about access to public information have caught my eye in the past week. Whether it involves public health data from Florida, evidence in a federal criminal case or embargoes and favored access at a federal agency, it’s clear that journalists are facing obstacles in ensuring the public’s access to information.

In Rhode Island, a judge ruled in favor of a journalist seeking evidence presented in the trial of a doctor now “serving four life sentences for his role in operating a pain management clinic like a ‘pill mill.'” The U.S. Drug Enforcement Administration had refused to release the records since journalist Phil Eil requested them after the trial ended in 2011. Continue reading

FOIA lawsuit uncovers audits showing 35 health plans overbilled Medicare Advantage

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Fred Schulte

A federal review of health insurers operating Medicare Advantage plans shows that 35 health plans overbilled the federal Centers for Medicare & Medicaid Services, the Center for Public Integrity reported on August 29.

Fred Schulte, a CPI senior reporter, said the center obtained 37 MA plan audits through a Freedom of Information Act lawsuit. The documents indicated that 35 of those health plans were overpaid in 2007. The typical overpayment was several hundred thousand dollars.

“Among the insurers charging the government too much: five Humana, Inc. health plans, three UnitedHealth Care Group plans and four Wellpoint, Inc. plans,” Schulte wrote. None of the plans would comment for Schulte’s article. Continue reading

AHCJ webcast to examine drug prices, other cost challenges

Susan Heavey

About Susan Heavey

Susan Heavey, (@susanheavey) a Washington, D.C.-based journalist, is AHCJ’s topic leader on social determinants of health and curates related material at healthjournalism.org. She welcomes questions and suggestions on resources and tip sheets at determinants@healthjournalism.org.

Photo" Phillip Bradshaw via Flickr

Photo” Phillip Bradshaw via Flickr

Mylan’s price hike for its EpiPen allergy medication fueled an Internet storm this week, with consumers and U.S. legislators expressing outrage over its decision to raise the price about 400% since 2007 to as much as $500 or more. The backlash appeared tied in part to timing as U.S. children head back to school, with parents of those needing EpiPens to treat allergic reactions coming to grips with the hefty price tag.

The incident brought echoes of another drug price hike – the 2015 increase by Turing Pharmaceutical’s malaria and HIV medicine Darapim, another move that brought scrutiny by the House Oversight and Government Reform Committee of the company’s chief executive officer. Continue reading

Incremental progress seen in price transparency, but report may rate A+ among journalists

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Source: Report Card on State Price Transparency Laws — July 2016, Health Care Incentives Improvement Institute, Sandy Hook, Conn., and Catalyst for Payment Reform, San Francisco.Here’s how price transparency should work for a woman with a silver-level insurance plan in one state. Assume this consumer could go to any hospital and would choose based on the cost of care, meaning her out-of-pocket costs (deductible plus co-insurance). She could pay $5,079 at the highest-priced facility or $3,531 at the lowest-priced hospital. The difference between the two is $1,548.

Source: Report Card on State Price Transparency Laws — July 2016Here’s how price transparency should work for a woman with a silver-level insurance plan in one state. Assume this consumer could go to any hospital and would choose based on the cost of care, meaning her out-of-pocket costs (deductible plus co-insurance). She could pay $5,079 at the highest-priced facility or $3,531 at the lowest-priced hospital. The difference between the two is $1,548.

Progress toward widespread price transparency comes slowly, according to the latest annual report from the Health Care Incentives Improvement Institute (HCI3) and the Catalyst for Payment Reform (CPR). In the “Report Card on State Price Transparency Laws – July 2016,” issued on Tuesday, the authors, Suzanne Delbanco, CPR’s executive director, and François de Brantes, HCI3’s executive director, explained what states are doing to give consumers the information they need to shop for care based on price.

As in past years, most states are doing poorly: 43 states earned an F grade for failing to meet even minimum standards. Last year, 45 states got an F. Continue reading

HIPAA experts: No need to request a waiver after Orlando shooting

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

emergency-roomSince Sunday’s horrific shooting in Orlando that killed 49 people and injured 53 patrons at the Pulse night club, journalists have been asking whether the Health Insurance Portability and Accountability Act of 1996 (HIPAA) limits what hospital administrators can say about a patient’s condition.

One source of confusion was a statement made by Orlando Mayor Buddy Dyer after the June 12 attack. Continue reading