Articles by John Tozzi and Emma Court

Surprise Medical Bill Moving in Congress Could Help Insurers As Well as Patients

Congress is closing in on a deal that could shield patients from surprise medical bills, eliminating a source of frustration for Americans who face unexpected charges from emergency care and other procedures. The question for the health-care industry is whether …

At $20K a Year, Health Insurance Costs Undermine Job-Based Health Insurance

The cost of family health coverage in the U.S. now tops $20,000, an annual survey of employers found, a record high that has pushed an increasing number of American workers into plans that cover less or cost more, or force …

Gene Therapy Drugs That Cost Millions Have Employers and Health Plans Worried

Employers and health plans fear they could be swamped financially by a coming wave of expensive new genetic therapies for rare diseases. Regulators have recently approved two treatments that sell at many multiples of the prices of routine treatments for …

Judge Permits Short-Term Health Plans in Blow to Obamacare Supporters

The Trump administration can expand the sale of short-term health insurance policies that don’t meet the standards of the Affordable Care Act, a federal judge ruled, advancing the government’s efforts to undo Obamacare. U.S. District Judge Richard Leon in Washington …

Trump Moves to Force Hospitals, Insurers to Disclose Prices

The Trump administration took a step toward making paying for health care more like paying for coffee, computers or clothing, by letting patients know prices up front — but what consumers could do with that information once they have it …

How Trump Is Remaking Health Insurance Without Repealing Obamacare

President Donald Trump’s attempt to transform American health insurance is almost complete. Twenty months ago, frustrated after attempts to repeal Obamacare fell apart in the Republican-controlled Senate, Trump pledged to use executive power to do what Congress failed to legislate. …

Doctors, Insurer Propose Tracking Patients’ ‘Social Conditions’ for Referrals

If you get struck by lightning or bitten by a pig, a physician can record that information with a code shorter than your phone number. But if you can’t afford your bills, doctors and health plans have no consistent way …

Senators Pitch Baseball-Like Arbitration to End Unexpected Medical Bills

In most markets, when a buyer and a seller can’t settle on a price, they walk away. Medicine is different. Doctors and insurance companies often sort out who owes what only after a patient has been treated, especially in emergencies. …

Employees’ Share of Health Costs Continues Rising Faster Than Wages

Annual family premiums for employer-sponsored health insurance rose five percent to an average $19,616 this year, extending a seven-year run of moderate increases.The average single deductible now stands at $1,573 for those workers who have one, similar to last year’s …

Doctor’s Alleged Fraud Scheme Throws Medical Claims Review Process into Doubt

For years, Spyros Panos seemed like a successful orthopedic surgeon, seeing dozens of patients a day and bringing in millions of dollars in fees for his suburban New York medical group. In fact, he was inflating charges and billing for …