Morning Briefing
Summaries of health policy coverage from major news organizations
Seniors Switch To Traditional Medicare Plans When More Serious Conditions Hit, Study Shows
NPR: Seniors Tend To Quit Medicare Advantage When Health Declines
Senior citizens are switching from privately run insurance plans to traditional Medicare when they face serious, long-term health conditions, a study shows. Researchers at Brown University found that 17 percent of Medicare Advantage patients who entered nursing homes for long-term care chose to switch to traditional Medicare the following year. Only 3 percent of similar patients in Medicare made the decision to go to a private Medicare Advantage plan. (Kodjak, 10/6)
The Associated Press: Supreme Court Hears UPMC's Appeal Of Medicare Ruling
The University of Pittsburgh Medical Center asked the Pennsylvania Supreme Court on Tuesday to vacate a lower court's order forcing UPMC to maintain cheaper, in-network rates for Highmark Inc.'s 182,000 Medicare Advantage customers. Commonwealth Court Judge Dan Pellegrini ordered UPMC in May to maintain the cheaper rates through 2019 for Medicare Advantage subscribers who use UPMC's doctors and hospitals. His ruling came after UPMC tried to cancel its in-network contract with Highmark's Medicare Advantage plan. (Mandak, 10/6)
St. Louis Public Radio: Medicare Enrollment Starts This Month. Here's What You Need To Know
Open enrollment for Medicare starts this month, on Oct. 15, and closes Dec. 7. It is the only time of the year that plan beneficiaries have the ability to change their Medicare health and drug plans. Plan costs and coverage benefits seem to change almost as soon as they are enacted. Around 1700 people in the St. Louis area alone will be impacted by their Medicare Advantage plan not renewing their contract with Medicare, making open enrollment an important part of the year to pay attention to. (Moffitt, 10/6)
Connecticut Health I-Team: Medicare Advantage Plans Need Tougher Oversight, GAO Says
Federal investigators have found that Medicare officials rarely enforce rules for private insurance plans intended to make sure beneficiaries will be able to see a doctor when they need care. ... The report by the Government Accountability Office, the investigative arm of Congress, said that Medicare did not check provider networks to ensure that doctors were available to beneficiaries and cited Connecticut as a “case study” in what can go wrong. (Jaffe, 10/5)
The New York Times: The Hurdles To Getting Hearing Aids
But perhaps the more important reason people fail to get hearing aids when they are needed is the cost, which is rarely covered by insurance and not at all by Medicare, unless the device is for a child. Properly fitted, up-to-date digital aids for both ears, like those Dr. Hammel wears, cost thousands of dollars. (His were $5,600, which is fairly typical.) Many people, especially older people living on fixed incomes, can’t afford them and can’t understand why such a basic health need is overlooked by private and government insurance. (The same lack of insurance coverage is often true for eyeglasses, incidentally.) (Brody, 10/6)
Meanwhile, rules protecting home health care workers can go forward -
The Associated Press: Chief Justice Won't Delay Wage Rules For Home Care Workers
Supreme Court Chief Justice John Roberts won't hold up new Obama administration regulations that give overtime and minimum wage protections to nearly 2 million home health care workers. Roberts on Tuesday denied an emergency request from three home care industry trade groups that said the rules set to take effect Oct. 13 threaten irreparable harm to businesses that provide in-home care for the elderly and disabled. (10/6)
