Health Insurance Hustle
The Confounding Way We Pay for Care
Americans pay insurance companies to make sure their medical needs are covered — and at a cost they can afford. But games, side deals and hidden incentives often result in higher costs, delays in care or denials of treatment.
Lavish Bonus? Luxury Trip? Health Benefits Brokers Will Have to Disclose What They Receive From the Insurance Industry
Employers trust brokers to guide them to the best value, but conflicts of interest abound. Tucked into the coronavirus relief bill, a new federal requirement will mandate more transparency.
We Showed How Easy It Is to Commit Health Care Fraud. Now Senators Want to Close the Loophole.
The bipartisan proposal comes in response to a ProPublica story that showed how a personal trainer posed as a doctor to defraud prominent health insurers.
Un hospital cobra a una de sus enfermeras casi $900,000 tras dar a luz a una bebé prematura
Según Dignity Health, la enfermera de emergencias no cumplió con la fecha límite para agregar a su recién nacida prematura a su plan de salud, lo que la hacía responsable de las facturas médicas. La empresa rechazó las apelaciones de su empleada durante un año hasta que ProPublica se puso en contacto con ellos.
How One Employer Stuck a New Mom With an $898,984 Bill for Her Premature Baby
Dignity Health said its employee, an ER nurse, failed to meet the deadline to add her premature newborn to its health plan, so she was responsible for the medical bills. It rejected her appeals for a year until ProPublica called.
Senators Call for Closing “Loopholes” That Make Health Care Fraud Easy
In response to a story by ProPublica and Vox that detailed how a Texas personal trainer was able to bilk private insurers for millions, six Democratic lawmakers are asking federal regulators to take action.
Senators Call for Disclosure of Perks and Fees Paid to Health Benefits Brokers
A ProPublica story in February documented the hidden cash and gifts health insurers pay to influence independent brokers. In new proposed legislation, lawmakers say such fees should be revealed to employers.
What We’re Watching
During Donald Trump’s second presidency, ProPublica will focus on the areas most in need of scrutiny. Here are some of the issues our reporters will be watching — and how to get in touch with them securely.
Learn more about our reporting team. We will continue to share our areas of interest as the news develops.
Sharon Lerner
I cover health and the environment and the agencies that govern them, including the Environmental Protection Agency.
Andy Kroll
I cover justice and the rule of law, including the Justice Department, U.S. attorneys and the courts.
Melissa Sanchez
I report on immigration and labor, and I am based in Chicago.
Jesse Coburn
I cover housing and transportation, including the companies working in those fields and the regulators overseeing them.
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