The Medicare Advantage Influence Machine
By Fred Schulte Holly K. Hacker
September 30, 2024
KFF Health News Original
New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges.
Federal Watchdog Urges Crackdown on Medicare Advantage Home Visits
By Fred Schulte
November 22, 2024
KFF Health News Original
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 […]
Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits
By Fred Schulte
November 8, 2024
KFF Health News Original
Medicare officials defend the use of home visits that often spot medical conditions that are never treated.
Hospitals and Doctors Are Fed up With Medicare Advantage
By Julie Appleby
November 29, 2023
KFF Health News Original
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 Advantage Increasingly Popular With Seniors — But Not Hospitals and Doctors
By Julie Appleby
November 29, 2023
KFF Health News Original
Some hospitals and physician groups are rejecting Medicare Advantage plans over payment rates and coverage restrictions, causing turmoil for patients.
KFF Health News Sues To Force Disclosure of Medicare Advantage Audit Records
By Fred Schulte
November 12, 2024
KFF Health News Original
Freedom of Information Act case targets HHS inspector general’s reviews of billions of dollars in health plan overpayments.
Feds Killed Plan To Curb Medicare Advantage Overbilling After Industry Opposition
By Fred Schulte
August 27, 2024
KFF Health News Original
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.
Older Americans Say They Feel Trapped in Medicare Advantage Plans
By Sarah Jane Tribble
January 5, 2024
KFF Health News Original
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.
Medicare Advantage Is Popular, but Some Beneficiaries Feel Buyer’s Remorse
By Sarah Jane Tribble
January 23, 2024
KFF Health News Original
Medicare Advantage plans are booming — 30.8 million of the 60 million Americans with Medicare are now enrolled in the private plans rather than the traditional government-run program. But a little-known fact: Once you’re in a Medicare Advantage plan, you may not be able to get out. Traditional Medicare usually requires beneficiaries to pay 20 […]
Watch: Older Americans Say They Feel Stuck in Medicare Advantage Plans
By Sarah Jane Tribble
January 22, 2024
KFF Health News Original
You’ve probably seen advertising about Medicare Advantage plans. KFF Health News’ Sarah Jane Tribble explains the pros and cons of this insurance option as enrollment in these plans increases.
Election Outcome Could Bring Big Changes to Medicare
By Stephanie Armour
Updated November 4, 2024
Originally Published November 4, 2024
KFF Health News Original
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.
KFF Health News' 'What the Health?': The Policy, and Politics, of Medicare Advantage
March 23, 2023
Podcast
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.
Uncle Sam Wants You … to Help Stop Insurers’ Bogus Medicare Advantage Sales Tactics
By Susan Jaffe
November 30, 2023
KFF Health News Original
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.
Adultos mayores, detectives contra avisos engañosos de Medicare Advantage
By Susan Jaffe
November 30, 2023
KFF Health News Original
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.
Readers Weigh Downsides of Medicare Advantage and Stick Up for Mary Lou Retton
January 29, 2024
KFF Health News Original
KFF Health News gives readers a chance to comment on a recent batch of stories.
Tiny, Rural Hospitals Feel the Pinch as Medicare Advantage Plans Grow
By Sarah Jane Tribble
October 23, 2023
KFF Health News Original
More than half of seniors are enrolled in private Medicare Advantage plans instead of traditional Medicare. Rural enrollment has increased fourfold and many small-town hospitals say that threatens their viability.
Adultos mayores se sienten “atrapados” en planes de Medicare Advantage
By Sarah Jane Tribble
January 5, 2024
KFF Health News Original
Al parecer el programa de planes privados para adultos mayores comienza a presentar obstáculos cuando surgen enfermedades.
Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage
By Susan Jaffe
March 29, 2024
KFF Health News Original
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.
Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients
By Susan Jaffe
October 5, 2023
KFF Health News Original
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+
By Stephanie Stephens
September 28, 2023
KFF Health News Original
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.
