Medicare Advantage ‘Dark Money’ Group Attempts To Win Higher Payments for Insurance Companies

Medicare Advantage insurers say a proposal by the Trump administration to keep their payments nearly flat next year may lead to service cuts that harm seniors struggling to afford health care. A decision is due by early next month.

Blurry Line Between Medical and Vision Insurance Leaves Patient With Unexpected Bill

A Wisconsin retiree with glaucoma needed her eyes examined. Her Medicare Advantage plan from UnitedHealthcare listed her optometrist’s clinic as in-network, but she learned the hard way that a clinic can be in-network and out-of-network at the same time.

Medicare Advantage Insurers Face New Curbs on Overcharges in Trump Plan That Reins in Payments

Proposed Trump administration changes to federal Medicare Advantage payments would stop health insurers from mining patient data for extra medical diagnoses that generate more bills to taxpayers even without treatment.

Sick of Fighting Insurers, Hospitals Offer Their Own Medicare Advantage Plans

Breakups between insurers and health systems, on top of plan cuts, left more than 3.7 million Medicare Advantage enrollees facing a tough choice last year: find new insurance or new doctors. But hospital systems say their Advantage plans can avert such upheaval, giving patients peace of mind.

These 3 Policy Moves Are Likely To Change Health Care for Older People

Two Trump administration regulatory rollbacks affect nursing home staffing and home care workers, and a new AI experiment in Medicare has alarmed eldercare advocates and congressional Democrats.

Judge in Nursing Home Bankruptcy Case Gives Families Fresh Hope of Compensation for Injuries, Deaths

Genesis HealthCare’s controlling investor, Joel Landau, had sought to rebuy the nursing homes while gaining protection from settlement payments over allegations of poor care. A judge rejected the proposal and ordered a new auction. A KFF Health News investigation found Genesis settled hundreds of lawsuits but didn’t pay them out fully.

How Delays and Bankruptcy Let a Nursing Home Chain Avoid Paying Settlements for Injuries and Deaths

Genesis HealthCare’s bankruptcy case in Dallas will allow the nursing home chain to avoid paying millions of dollars it promised for residents who were injured or died while in its care. Families say bankruptcy nullifies one of the main ways to hold nursing home owners accountable for poor care.

More People Are Caring for Dying Loved Ones at Home. A New Orleans Nonprofit Is Showing Them How.

Demand for home health care, including at-home hospice care, has skyrocketed since the onset of the covid pandemic. A New Orleans nonprofit is teaching people how to provide end-of-life care for relatives and community members.

Complaints About Gaps in Medicare Advantage Networks Are Common. Federal Enforcement Is Rare.

Health systems drop out of Medicare Advantage plans all the time. Yet government documents obtained by KFF Health News show that federal regulators rarely warn plans that their networks of health providers are so skimpy they violate legal requirements.