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KFF Health News' 'What the Health?': Nursing Home Staffing Rules Prompt Pushback

Podcast

The nursing home industry — as well as a healthy number of Congress members — are all pushing back on the Biden administration’s new rules on nursing home staffing. Industry officials say that there are not enough workers to meet the requirements and that the costs would be prohibitive. Meanwhile, Democrats on Capitol Hill are trying to force Republicans to explain their exact positions on assuring access to contraceptives and in vitro fertilization. Rachel Cohrs Zhang of Stat, Alice Miranda Ollstein of Politico, and Sandhya Raman of CQ Roll Call join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews KFF Health News’ Bram Sable-Smith, who reported and wrote the latest KFF Health News-NPR “Bill of the Month” feature about a free cruise that turned out to be anything but.

Medicare Stumbles Managing a Costly Problem — Chronic Illness

KFF Health News Original

Nearly a decade ago, Medicare launched a program to help the two-thirds of beneficiaries with chronic conditions by paying their doctors an additional monthly fee to coordinate their care. The strategy has largely failed to live up to its potential; only about 4 percent of potentially eligible beneficiaries in the traditional Medicare program are enrolled, […]

Unauthorized Sign-Ups Cast Shadow on Obamacare’s Record Enrollment

KFF Health News Original

The Biden administration faces what looks like a growing problem for the federal Affordable Care Act’s insurance exchange: disreputable insurance brokers enrolling people who don’t need coverage or switching them to new plans without their authorization. It happened to Michael Debriae, a restaurant server who lives in Charlotte. Unbeknownst to him, an agent in Florida […]

Biden Cracks Down on Prior Authorization — But There Are Limits

KFF Health News Original

More than a year after it was initially proposed, the Biden administration announced a final rule yesterday that will change how insurers in federal programs such as Medicare Advantage use prior authorization — a long-standing system that prevents many patients from accessing doctor-recommended care. “When a doctor says a patient needs a procedure, it is […]

Will CMS Crack Down on Prior Authorization?

KFF Health News Original

There’s the Idaho doctor whose infant daughter developed a brain tumor. A woman in Southern California who waited months for an MRI before dying in the hospital. And a North Carolina patient who has trigeminal neuralgia — a condition so painful it’s commonly called the “suicide disease.” They all have something in common, aside from […]

Medicaid’s ‘Unwinding’ Can Be Especially Perilous for Disabled People

KFF Health News Original

Earlier this year, Beverly Likens thought she’d done everything she needed to do to keep her Medicaid. Then came an unwelcome surprise: Ahead of surgery to treat chronic bleeding, the hospital said her insurance was inactive, jeopardizing her procedure. Likens had just been diagnosed with severe anemia and given a blood transfusion at the emergency room. “I […]