Author archive for lhigashi

By Tom WilemonTennesseans who got caught in a backlog of Medicaid applications are facing new hurdles despite a federal judge's order that TennCare fix the problem.U.S. District Judge Todd Campbell on Sept. 2 ordered the agency to set up a timely appeals process for potentially thousands of people whose…

Health plans are finding loopholes in the Affordable Care Act and excluding some of the neediest patients, consumer groups say.By Kimberly LeonardA recent, highly publicized editorial is claiming that some insurance companies are not making cheaper alternatives to certain prescriptions available, causing some of the sickest – and therefore…

By Bob EgelkoGroto Ni, a 55-year-old unemployed janitor from Oakland, applied for Medi-Cal in January and said he spent nearly five months in pain from hepatitis, ulcers and other health problems before the state approved his application.Frances Rivera of Visalia said her adult son also applied for Medi-Cal in…

By Kevin DrumVia ProPublica, here's an editorial published yesterday in the American Journal of Managed Care:For many years, most insurers had formularies that consisted of only 3 tiers: Tier 1 was for generic drugs (lowest co-pay), Tier 2 was for branded drugs that were designated “preferred” (higher co- pay),…

By Judy LinSACRAMENTO, Calif.—Medi-Cal patients and health care advocates filed a lawsuit against the state Wednesday for leaving hundreds of thousands of low-income and disabled people waiting months for care.The suit filed in Alameda County Superior Court aims to get the California Department of Health Care Services to process…