Medicare and Aging: March 30, 2023

Congressman Seeks to Plug ‘Shocking Loophole’ Exposed by KHN Investigation

Sarah Jane Tribble

A federal lawmaker has introduced a House bill that would close one of a laundry list of oversight gaps revealed in a recent KHN investigation of the system regulators use to ban fraudsters from billing government health programs, including Medicare and Medicaid.

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.

Mental Health Care by Video Fills Gaps in Rural Nursing Homes

Tony Leys

In-person mental health care is hard to arrange in rural nursing homes, so video chats with faraway professionals are filling the gap.

Judging the Abortion Pill

Any day now a conservative federal judge in Texas could upend the national abortion debate by requiring the FDA to rescind its approval of mifepristone, a drug approved in the U.S. more than 20 years ago that is now used in more than half of abortions nationwide. Meanwhile, a controversial study on masks gets a clarification, although it may be too late to change the public impression of what it found. Alice Miranda Ollstein of Politico, Jessie Hellmann of CQ Roll Call, and Sarah Karlin-Smith of the Pink Sheet join KHN chief Washington correspondent Julie Rovner to discuss these issues and more. Plus, for “extra credit,” the panelists suggest health policy stories they read this week they think you should read, too.

Biden Budget Touches All the Bases

Very little in the proposed budget released by the Biden administration is likely to become law, particularly with Republicans in charge of the U.S. House. Still, the document is an important statement of the president’s policy priorities, and it’s clear health programs are among those he feels are important. Meanwhile, five women who were denied abortions when their pregnancies threatened their lives are suing Texas. Shefali Luthra of The 19th, Victoria Knight of Axios, and Margot Sanger-Katz of The New York Times join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Harris Meyer, who reported and wrote the two latest KHN-NPR “Bill of the Month” features. Both were about families facing unexpected bills following childbirth.

Covid Aid Papered Over Colorado Hospital’s Financial Shortcomings

Markian Hawryluk

Financial pitfalls at the nation’s highest-elevation hospital serve as a cautionary tale as rural hospitals emerge from the pandemic on shaky ground.

For Young People on Medicare, a Hysterectomy Sometimes Is More Affordable Than Birth Control

Gina Jiménez

While Medicare was designed as health insurance for those 65 and older, it also covers people with disabilities who are young enough to still get pregnant. Yet they often struggle to get their birth control covered and end up with large medical bills — or instead opt for hysterectomies or tubal ligations, which Medicare sometimes will cover.

Struggling to Survive, the First Rural Hospitals Line Up for New Federal Lifeline

Sarah Jane Tribble

Hospitals in New Mexico, Texas, and Oklahoma are among the first to apply for a new rural hospital payment model that shifts the focus of services away from overnight stays to outpatient and emergency care. Still, experts say the law needs to be amended to provide the right mix of care for rural communities.

Being ‘Socially Frail’ Comes With Health Risks for Older Adults

Judith Graham

Researchers are identifying new ways to assess older adults’ social circumstances and identify risks that can compromise their health. “It’s a more complete picture of older adults’ circumstances than any one factor alone,” one expert said.

End of Covid Emergency Will Usher in Changes Across the US Health System

Rachana Pradhan

The May 11 expiration of the federal government’s pandemic emergency declaration will affect patient care across a broad range of settings, including telemedicine, hospitals, and nursing homes.

Seniors With Anxiety Frequently Don’t Get Help. Here’s Why.

Judith Graham

Older people often aren’t being screened for anxiety disorders, even though it is a common affliction — one masked by other problems when growing old.

After People on Medicaid Die, Some States Aggressively Seek Repayment From Their Estates

Tony Leys

States take drastically different approaches to recovering Medicaid money from deceased participants’ estates. Demands for repayment of Medicaid spending can drain the assets a person leaves behind, depending on where they lived.