Latest KFF Health News Stories
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 […]
Adultos mayores se sienten “atrapados” en planes de Medicare Advantage
Al parecer el programa de planes privados para adultos mayores comienza a presentar obstáculos cuando surgen enfermedades.
Older Americans Say They Feel Trapped in Medicare Advantage Plans
As enrollment in private Medicare Advantage plans grows, so do concerns about how well the insurance works, including from those who say they have become trapped in the private plans as their health declines.
What the Health? From KFF Health News: 2023 Is a Wrap
2023 was another busy year in health care. As the covid-19 pandemic waned, policymakers looked anew at long-standing obstacles to obtaining and paying for care in the nation’s health care system. Meanwhile, abortion has continued to be an issue in much of the nation, as states respond to the Supreme Court’s 2022 decision overturning the constitutional right to the procedure. This week, Rachel Cohrs of Stat, Sandhya Raman of CQ Roll Call, and Joanne Kenen of Johns Hopkins University and Politico Magazine join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and wrap up the year in health. Also this week, Rovner interviews KFF Health News’ Jordan Rau about his joint KFF Health News-New York Times series “Dying Broke.”
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.
Medicare Advantage Increasingly Popular With Seniors — But Not Hospitals and Doctors
Some hospitals and physician groups are rejecting Medicare Advantage plans over payment rates and coverage restrictions, causing turmoil for patients.
Hospitals and Doctors Are Fed up With Medicare Advantage
Medicare Advantage plans are pretty popular with both lawmakers and ordinary Americans — they now enroll about 31 million people, representing just over half of everyone in Medicare, by KFF’s count. But among doctors and hospitals, it’s a different story. Across the country, provider grumbling about claim denials and onerous preapproval requirements by Advantage plans […]
Medicare Enrollees Can Switch Coverage Now. Here’s What’s New and What to Consider.
Fall is the time when enrollees in the federal program for older people and people with certain disabilities can make changes to their health and drug plans. The decision can be complicated, but here are some key points to keep in mind.
Es el momento de revisar el plan de Medicare. Lo nuevo que hay que saber
Desde el 15 de octubre y hasta el 7 de diciembre, los afiliados al programa tradicional o a los planes de Medicare Advantage, que ofrecen aseguradoras privadas, pueden cambiar su cobertura.
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.
New Medicare Advantage Plans Tailor Offerings to Asian Americans, Latinos, and LGBTQ+
As more seniors opt for Medicare Advantage, a few small insurers have begun offering plans that provide culturally targeted benefits for cohorts including Asian Americans, Latinos, and LGBTQ+ people. The approach, policy researchers say, has potential and perils.
Nuevos planes de Medicare Advantage adaptan ofertas para asiáticos, latinos y LGTBQ+
A medida que Medicare Advantage gana popularidad entre los adultos mayores, tres compañías del sur de California están lanzando nuevos planes que se enfocan en comunidades culturales y étnicas, con ofertas especiales y profesionales que hablan su idioma nativo.
What the Health? From KFF Health News: The Policy, and Politics, of Medicare Advantage
Medicare Advantage, the private plan alternative to traditional Medicare, is embroiled in a growing controversy over whether insurers are being overpaid and what it would mean to reduce those payments. Meanwhile, even as maternal mortality in the U.S. continues to rise, providers of care to pregnant women say they’re leaving states with abortion bans that prevent them from treating pregnancy complications. Margot Sanger-Katz of The New York Times, Jessie Hellmann of CQ Roll Call, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico join KHN’s chief Washington correspondent Julie Rovner to discuss these issues and more.
Proposed Medicare Advantage Changes Cannot Accurately Be Called ‘Cuts,’ Experts Say
CMS advanced two proposed changes that could affect Medicare Advantage plans. One would allow the government to recover past overpayments. As a result, it could reduce those insurers’ profits, leading them to increase enrollees’ out-of-pocket costs or reduce benefits. But it’s inaccurate to characterize the changes as “cuts.”
What the Health? From KFF Health News: Au Revoir, Public Health Emergency
The Biden administration this week announced it would let the covid-19 public health emergency lapse on May 11, even as the Republican-led House was voting to immediately eliminate the special authorities of the so-called PHE. Meanwhile, anti-abortion forces are pressuring legislators to both tighten abortion restrictions and pay for every birth in the nation. Margot Sanger-Katz of The New York Times, Rachel Roubein of The Washington Post, and Victoria Knight of Axios join KHN’s chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Hannah Wesolowski of the National Alliance on Mental Illness about the rollout of the national 988 suicide prevention hotline.
Government Lets Health Plans That Ripped Off Medicare Keep the Money
In a surprise decision, U.S. officials yield to insurance industry demands — at least for now.
Did Your Health Plan Rip Off Medicare?
KHN has released never-before-seen details of federal audits as the government weighs action against dozens of Medicare Advantage plans.
How Medicare Advantage Plans Dodged Auditors and Overcharged Taxpayers by Millions
Facing rare scrutiny from federal auditors, some Medicare Advantage health plans failed to produce any records to justify their payments, government records show. The audits revealed millions of dollars in overcharges to Medicare over three years.
