Latest KFF Health News Stories
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.
KFF Health News' 'What the Health?': Nursing Home Staffing Rules Prompt Pushback
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.
Exclusive: Senator Urges Biden Administration To Thwart Fraudulent Obamacare Enrollments
With tens of thousands of Americans already affected by enrollment scams that leave some without doctors or treatments, Oregon Sen. Ron Wyden wants increased enforcement against rogue agents or other perpetrators and legislation to allow for criminal penalties.
Journalists Demystify Bird Flu, Brain Worms, and New Staffing Mandates for Nursing Homes
KFF Health News and California Healthline staff made the rounds on national and local media in recent weeks to discuss topical stories. Here’s a collection of their appearances.
Medicare Stumbles Managing a Costly Problem — Chronic Illness
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, […]
Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don’t Meet Them.
The staffing regulation was disparaged by the industry as unattainable. Patient advocates say it doesn’t go far enough. Labor unions welcomed the requirement.
Lawsuit Alleges Obamacare Plan-Switching Scheme Targeted Low-Income Consumers
The lawsuit filed in federal court alleges that large call centers were used to enroll people into Affordable Care Act plans or to switch their coverage, all without their permission.
When Rogue Brokers Switch People’s ACA Policies, Tax Surprises Can Follow
Some tax filers’ returns are being rejected because they failed to provide information about Affordable Care Act coverage they didn’t even know they had.
Unauthorized Sign-Ups Cast Shadow on Obamacare’s Record Enrollment
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 […]
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.
Biden Cracks Down on Prior Authorization — But There Are Limits
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?
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 […]
Readers Slam Hospital Monopolies and Blame the Feds for Understaffed Nursing Homes
KFF Health News gives readers a chance to comment on a recent batch of stories.
Medicaid’s ‘Unwinding’ Can Be Especially Perilous for Disabled People
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 […]
Lost in the Mix of Medicaid ‘Unwinding’: Kentucky Cut Off Her Health Care Over a Clerical Error
The state canceled Beverly Likens’ coverage — days before surgery — without considering other ways she qualified for Medicaid, which experts say violated federal regulations.
Nursing Homes Say They Can’t Afford Higher Staffing. But Their Finances Are Often Opaque.
Perhaps the biggest mystery, as the Biden administration moves to force nursing homes to boost staffing, is this: how much extra money do the nation’s 15,000 homes actually have to hire and retain more nurses and aides? Public comments are due Monday on the most sweeping regulatory changes to hit the industry in decades. The […]
