Latest KFF Health News Stories
Trump’s DOJ Accuses Medicare Advantage Insurers of Paying ‘Kickbacks’ to Brokers
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Trump’s DOJ Accuses Medicare Advantage Insurers of Paying ‘Kickbacks’ for Primo Customers
The Department of Justice alleges that several major health insurers paid brokerages “hundreds of millions of dollars in kickbacks” to get agents to steer consumers into their Medicare Advantage plans, allegations the insurers strongly dispute.
When Hospitals Ditch Medicare Advantage Plans, Thousands of Members Get To Leave, Too
Breakups between health providers and Advantage plans are increasingly common. The Centers for Medicare & Medicaid Services has allowed whole groups of patients to leave their plans.
KFF Health News' 'What the Health?': Can Congress Reconcile Trump’s Wishes With Medicaid’s Needs?
When Congress returns next week, it will be writing a budget reconciliation bill that’s expected to cut taxes but also make deep cuts to Medicaid. But at least some Republicans are concerned about cutting a program that aids so many of their constituents. Sarah Karlin-Smith of the Pink Sheet, Tami Luhby of CNN, and Alice Miranda Ollstein of Politico join KFF Health News’ Julie Rovner to discuss this story and more. Also, Rovner interviews KFF Health News’ Rae Ellen Bichell about her story on how care for transgender minors is changing in Colorado.
Some Rural Hospitals Ditch Medicare Advantage
Get our weekly newsletter, The Week in Brief, featuring a roundup of our original coverage, Fridays at 2 p.m. ET.
Rural Hospitals Question Whether They Can Afford Medicare Advantage Contracts
Some rural hospitals have canceled — or are considering ending — contracts with insurance companies that offer Medicare Advantage plans, saying the private policies jeopardize their finances and impede patient care.
UnitedHealth Wins Ruling Over $2B in Alleged Medicare Advantage Overpayments
A special master found the Justice Department failed to prove wrongdoing by the giant health insurer.
In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M
A whistleblower suit alleged a health insurer bilked Medicare by exaggerating how sick patients were.
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 […]
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.
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.
Election Outcome Could Bring Big Changes to Medicare
Democrats and conservatives are divided over whether the federal health program for people over 65 should be run almost entirely by the private sector. If Trump retakes the White House, the shift to Medicare Advantage may accelerate.
Vance Wrongly Blames Rural Hospital Closures on Immigrants in the Country Illegally
Experts disputed the claim by Republican vice presidential candidate JD Vance, noting that a range of other issues — from low reimbursement rates to declining patient use — combine to cause these facilities to shutter.
Patients Are Relying on Lyft, Uber To Travel Far Distances to Medical Care
Uber and Lyft have become a critical part of the nation’s infrastructure for transporting ailing people from their homes — even in rural areas — to medical care sites in major cities such as Atlanta.
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.
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.
Un grupo médico atiende a personas que viven en la calle… y gana dinero
Estos médicos, enfermeros y trabajadores sociales se están desplegando en las calles de Los Ángeles para ofrecer atención médica y servicios sociales a las personas sin hogar: soldados de un nuevo modelo de negocio que está arraigándose en comunidades de toda California.
A California Medical Group Treats Only Homeless Patients — And Makes Money Doing It
Healthcare in Action, a California medical group that exclusively serves homeless people, has tapped into growing demand and funding for street medicine services. Three years in, the innovative nonprofit is raking in revenue and serving thousands of people who otherwise might flock to the hospital for high-cost care.
