Biden Plan To Save Medicare Patients Money on Drugs Risks Empty Shelves, Pharmacists Say
President Joe Biden is campaigning for reelection on his efforts to cut costs for Medicare patients at the pharmacy counter. But independent pharmacists say one strategy makes it unaffordable for them to keep some brand-name medicines in stock.
Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage
Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. There’s a way out.
Dodging the Medicare Enrollment Deadline Can Be Costly
As open enrollment ends, many people are tuning out. They could wind up with a surprise next year: higher costs and less access to health care providers.
Adultos mayores, detectives contra avisos engañosos de Medicare Advantage
Funcionarios de los Centros de Servicios de Medicare y Medicaid le han pedido a las personas mayores y a otros miembros de la comunidad que sean detectives contra el fraude, denunciando tácticas de venta engañosas al 800-MEDICARE.
Uncle Sam Wants You … to Help Stop Insurers’ Bogus Medicare Advantage Sales Tactics
The Biden administration wants to crack down on deceptive or misleading Medicare Advantage and drug plan sales tactics. It’s counting on beneficiaries to help catch offenders.
Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients
Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and then predicts what kind of care an individual will need and for how long. New federal rules will ensure human experts are part of the process.
A Covid Test Medicare Scam May Be a Trial Run for Further Fraud
Before the covid-19 public health emergency ended, Medicare advocates around the country noticed a rise in complaints from beneficiaries who received at-home covid tests they never requested. Bad actors may have used seniors’ Medicare information to improperly bill the federal government — and could do it again, say federal investigators.
Estafas a Medicare con pruebas para covid pueden generar otros fraudes
La cobertura de Medicare para las pruebas caseras de covid-19 finalizó hace pocos días, pero las estafas generadas por este beneficio temporal podrían tener consecuencias persistentes para las personas mayores.
Medicare Plan Finder Likely Won’t Note New $35 Cap on Out-of-Pocket Insulin Costs
In August, Congress approved a $35 cap on what seniors will pay for insulin, but that change came too late to add to the online tool that helps Medicare beneficiaries compare dozens of drug and medical plans. Federal officials say beneficiaries who use insulin will have the opportunity to switch plans after open enrollment ends Dec. 7.
After Congress Fails to Add Dental Coverage, Medicare Weighs Limited Benefit Expansion
Medicare can pay for some dental care if it is medically necessary to safely treat another covered medical condition, and federal officials have asked for suggestions on whether that list of conditions should be expanded.
Nursing Home Surprise: Advantage Plans May Shorten Stays to Less Time Than Medicare Covers
Private Medicare Advantage health plans are increasingly ending coverage for skilled nursing or rehab services before medical providers think patients are healthy enough to go home, doctors and patient advocates say.
Medicaid Weighs Attaching Strings to Nursing Home Payments to Improve Patient Care
The Biden administration is considering whether Medicaid, which pays the bills for 62% of nursing home residents, should require that most of that funding be used to provide care, rather than for maintenance, capital improvements, or profits.
Medicare Surprise: Drug Plan Prices Touted During Open Enrollment Can Rise Within a Month
Even the savviest Medicare drug plan shoppers can get a shock when they fill prescriptions: That great deal on medications is no bargain after prices go up.
Seeking to Shift Costs to Medicare, More Employers Move Retirees to Advantage Plans
Private and public employers are increasingly using the government’s Medicare Advantage program as an alternative to their existing retiree health plan and traditional Medicare coverage. As a result, the federal government is paying the “overwhelming majority” of medical costs, according to an industry analyst.
Medicare Patients Win the Right to Appeal Gap in Nursing Home Coverage
If federal officials accept a court’s decision, some patients will get a chance to seek refunds for their nursing home and other expenses.
La inscripción de Medicare es temporada abierta para estafadores
Funcionarios federales dicen que están aumentando las quejas de personas mayores engañadas para que compren pólizas sin su consentimiento, o atraídas por información cuestionable, que pueden no cubrir sus medicamentos ni incluir a sus médicos.
Medicare’s Open Enrollment Is Open Season for Scammers
Medicare officials say complaints are rising from seniors lured into private plans with misleading information or enrolled without their consent. In response, officials have threatened to penalize the private companies selling Medicare Advantage and drug plans if they or agents working on their behalf mislead consumers.
3 States Limit Nursing Home Profits in Bid to Improve Care
Following the devastating impact of covid-19 on nursing homes, state lawmakers want to be sure that government and private payments primarily go to improve care and staffing.
After Pandemic Ravaged Nursing Homes, New State Laws Protect Residents
This year, 23 states passed more than 70 pandemic-related provisions affecting nursing homes, including measures setting minimum staffing levels, expanding visitation protections and limiting owners’ profit margins.
Zooming Into the Statehouse: Nursing Home Residents Use New Digital Skills to Push for Changes
Connecticut residents who learned how to communicate with family and friends through digital technology when their nursing homes closed to visitors last year used that skill to testify remotely during legislative hearings on bills affecting them.