Latest KFF Health News Stories
Efforts To Curb ACA Enrollment Fraud Face Real-World Test
The current Affordable Care Act open enrollment season is the first big test of new federal guardrails against fraud. The rules aim to head off unauthorized ACA plan enrollments or switches by rogue agents and entities looking to make money via enrollment commissions. Such sign-ups triggered more than 274,000 consumer complaints through August this year. […]
Anti-Fraud Efforts Meet Real-World Test During ACA Enrollment Period
The federal government put guardrails in place to limit unauthorized plan sign-ups and switches. But the changes could prove to be a burden to consumers.
Dicen que los esfuerzos contra el fraude en ACA han dado resultados. Pero hay que estar alerta
Los Centros de Servicios de Medicare y Medicaid atribuyen esta reducción a las medidas adoptadas para prevenir problemas de inscripción y cambios de planes, que ya habían generado más de 274,000 quejas hasta agosto.
Journalists Reflect on Trump Picks, Racism and Public Health, and Unnecessary Dental Implants
KFF Health News staff made the rounds on national and local media in the last two weeks to discuss topical stories. Here’s a collection of their appearances.
Federal Watchdog Urges Crackdown on Medicare Advantage Home Visits
Medicare officials are pushing back against a federal watchdog’s call to crack down on home visits by Medicare Advantage health plans — a practice the watchdog says may waste billions of tax dollars every year. In late October, a Health and Human Services inspector general audit found that the insurers pocketed $7.5 billion in 2023 from diagnosing health conditions that […]
Readers Embrace ‘Going It Alone’ Series on Aging and Chastise Makers of Pulse Oximeters
KFF Health News gives readers a chance to comment on a recent batch of stories.
TV’s Dr. Oz Invested in Businesses Regulated by Agency Trump Wants Him To Lead
Celebrity doctor Mehmet Oz recently held broad investments in health care, tech, and food companies. Were he confirmed to run the Centers for Medicare & Medicaid Services, his job would involve interacting with giants of the industry that have contributed to his wealth.
KFF Health News' 'What the Health?': Trump’s Nontraditional Health Picks
Not only has President-elect Donald Trump chosen prominent vaccine skeptic Robert F. Kennedy Jr. to lead the Department of Health and Human Services, Trump also has said he will nominate controversial TV host Mehmet Oz to run the Centers for Medicare & Medicaid Services, which oversees coverage for nearly half of Americans. Meanwhile, the lame-duck Congress is back in Washington with just a few weeks to figure out how to wrap up work for the year. Rachel Cohrs Zhang of Stat, Sandhya Raman of CQ Roll Call, and Riley Ray Griffin of Bloomberg News join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews Sarah Varney, who has been covering a trial in Idaho challenging the lack of medical exceptions in that state’s abortion ban.
What To Know About RFK Jr.’s Stances on Key Health Issues and What He Could Do at HHS
Robert F. Kennedy Jr., President-elect Donald Trump’s pick to lead the Department of Health and Human Services, is coming into the nomination process in an unusual position, with a long list of his own policy priorities separate from the president-elect’s, and a public promise by Trump to let him “go wild” on his ideas. Céline […]
KFF Health News Sues To Force Disclosure of Medicare Advantage Audit Records
Freedom of Information Act case targets HHS inspector general’s reviews of billions of dollars in health plan overpayments.
Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits
Medicare officials defend the use of home visits that often spot medical conditions that are never treated.
Long-Term Care Facilities Must Provide Addiction Care, Advocates Say
When you think about the opioid crisis, the image of adults in their 20s, 30s, even sometimes those who are middle-aged, may come to mind. Rightly so, since most overdose deaths occur in people between ages 25 and 64. But did you know older adults are increasingly at risk of overdosing from opioids, too? In fact, from 2021 […]
The Medicare Advantage Influence Machine
New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges.
Rural NC County Is Set To Reopen Its Shuttered Hospital With Help From a New Federal Program
One rural North Carolina county is on track to be among the first where a hospital reopens owing to a new federal hospital classification meant to help save small, struggling facilities.
ACA Enrollment Platforms Suspended Over Alleged Foreign Access to Consumer Data
Federal regulators provided more specifics about why they suspended two private sector Affordable Care Act enrollment sites, including concerns about potential overseas accessing of consumer data and suspicions of involvement in Obamacare enrollment and switching schemes. The companies reject the assertions.
Feds Killed Plan To Curb Medicare Advantage Overbilling After Industry Opposition
A private 2014 decision by the Centers for Medicare & Medicaid Services faces new scrutiny in a multibillion-dollar Justice Department fraud case against UnitedHealth Group.
Biden Administration Tightens Broker Access to Healthcare.gov To Thwart Rogue Sign-Ups
The Centers for Medicare & Medicaid Services said it has received more than 200,000 complaints in the first six months of the year about people being signed up for Obamacare plans or switched to new plans without their consent.
Trump Is Wrong in Claiming Full Credit for Lowering Insulin Prices
Though the Trump administration established a voluntary, temporary program lowering insulin costs for some older Americans on Medicare, the mandatory price caps implemented through Biden’s Inflation Reduction Act go significantly further.
HealthSherpa and Insurers Team Up To Curb Unauthorized ACA Enrollment Schemes
The initiative targets the biggest incentive driving fraudulent sign-ups and plan switches: the commissions that rogue agents or large call centers seek.
The Supreme Court Just Limited Federal Power. Health Care Is Feeling the Shockwaves.
A Supreme Court ruling restricting federal power will likely have seismic ramifications for health policy. A flood of litigation — with plaintiffs like small businesses, drugmakers, and hospitals challenging regulations they say are too expensive or burdensome and not authorized by law — could leave the country with a patchwork of disparate health regulations.
