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Humana Shares Plummet After Feds Slash Rating

October 3, 2024 Morning Briefing

Humana’s stock took a tumble after the provider admitted to the SEC that only about 1 in 4 of its members were signed up to Medicare Advantage plans rated four stars or more. Meanwhile, CMS is making it harder in 2025 for insurers to get top marks, due to changes in the way stars are calculated.

Medicare Enrollment Blitz Doesn’t Include Options to Move Into Medigap

By Harris Meyer November 9, 2021 KFF Health News Original

TV ads and mailings targeting seniors tout Medicare Advantage plans this time of year, but millions choosing traditional Medicare make a costly and difficult decision about Medigap coverage, which gets much less attention.

Cigna To Sell Its Medicare Business To Health Care Service Corp.

February 1, 2024 Morning Briefing

Cigna is shedding its troubled Medicare Advantage, Medigap, and Medicare part D plans that cover 3.6 million people. The business will be sold to Health Care Service Corp., a Blue Cross Blue Shield insurer.

Cyberattack Insurance In The Spotlight After UnitedHealth Hack

March 21, 2024 Morning Briefing

Meanwhile, UnitedHealth Group said its Change Healthcare subsidiary’s systems for handling medical claims were back online, about a month after the attack. Also in the news: Medicare Advantage, hospital staff shortages, and more.

CMS-Proposed Rules Would Cap Medicare Advantage Broker Incentives

November 7, 2023 Morning Briefing

The Centers for Medicare and Medicaid Services are launching a second-wave effort to target Medicaid Advantage marketing practices in an effort to ensure older Americans have access to Medicare supplemental benefits and drug coverage.

Democrats’ Plans to Expand Medicare Benefits May Pinch Advantage Plans’ Funding

By Michelle Andrews October 28, 2021 KFF Health News Original

As lawmakers weigh new spending provisions to cover dental, hearing and vision services for Medicare beneficiaries, a group supporting Medicare Advantage plans is airing commercials that raise concerns about the funding for those private plans.

Morning Briefing for Wednesday, September 27, 2023

September 27, 2023 Morning Briefing

Covid vaccine attitudes, shutdown watch, ARPA-H hubs, Medicare Advantage premiums, abortion law, drug pricing, and more are in the news.

CMS: Medicare Advantage Premiums To Slightly Rise Next Year

September 27, 2023 Morning Briefing

The Centers for Medicare and Medicaid Services estimates that Medicare Advantage plan premiums will increase from $0.64 per month on average in 2024. Separately, GAO says that CMS does not have useful data on private equity investments in the nursing home industry.

Senate Finance Panel Grills Medicare Advantage Brokers Over Incentives

October 19, 2023 Morning Briefing

The Senate Finance Committee held a hearing Wednesday, questioning national insurance brokers about their practice in guiding Medicare Advantage enrollees through choosing among many plan options. Financial incentives and privacy were among the issues discussed.

Health Care Providers Indirectly Hit By Medicare Advantage Star Rating Slips

November 21, 2023 Morning Briefing

The argument runs thus: Declining ratings prompt insurers to seek cost savings that then impact health providers. Separately, worries emerge that new nursing home ownership transparency rules may lead to private equity exits. Also in the news: cybersecurity, ADHD drugs, and more.

Justice Department Targets Data Mining in Medicare Advantage Fraud Case

By Fred Schulte September 14, 2021 KFF Health News Original

The feds’ civil suit links exaggerated patient bills to “tens of millions” in overcharges.

Medicare’s Open Enrollment Is Open Season for Scammers

By Susan Jaffe November 11, 2021 KFF Health News Original

Medicare officials say complaints are rising from seniors lured into private plans with misleading information or enrolled without their consent. In response, officials have threatened to penalize the private companies selling Medicare Advantage and drug plans if they or agents working on their behalf mislead consumers.

Why So Slow? Legislators Take on Insurers’ Delays in Approving Prescribed Treatments

By Michelle Andrews May 17, 2022 KFF Health News Original

Insurers say prior authorization requirements are intended to reduce wasteful and inappropriate health care spending. But they can baffle patients waiting for approval. And doctors say that insurers have yet to follow through on commitments to improve the process.

From ‘Physician Assistant’ to Medicare, Readers and Tweeters Mince No Words

December 8, 2021 KFF Health News Original

KHN gives readers a chance to comment on a recent batch of stories.

Hospitals Said They Lost Money on Medicare Patients. Some Made Millions, a State Report Finds.

By Fred Clasen-Kelly October 25, 2022 KFF Health News Original

A North Carolina state treasurer’s report found hospitals give conflicting information about whether they profit from Medicare patients. Experts said the findings are significant because they suggest the federal government has failed to closely watch the billions of dollars in tax breaks that nonprofit hospitals have received.

Say What? Hearing Aids Available Over-the-Counter for as Low as $199, and Without a Prescription

By Phil Galewitz October 17, 2022 KFF Health News Original

The cheaper over-the-counter aids are for adults with mild to moderate hearing loss — a market of tens of millions of people, many of whom have until now been priced out because prescription devices can cost thousands of dollars.

Regulations Take Aim At Misleading Medicare Ads As Enrollment Opens

October 17, 2023 Morning Briefing

New Biden administration rules crafted to combat deceptive Medicare marketing tactics face their first big test this enrollment season. Other open enrollment news relates to coinsurance changes, Medicare Advantage, and more.

Democrats Plan to Expand Medicare Hearing Benefits. What Can Consumers Expect?

By Rachana Pradhan November 5, 2021 KFF Health News Original

KHN answers questions for seniors about how this new benefit might work.

Cardiologists Suggest Health Records Should Note Gender Identity

January 26, 2024 Morning Briefing

Since little is known about unique health challenges LGBTQ+ people face, Stat says, researchers are pushing for health systems to record patients’ sexual orientation and gender identity and expression to boost data collection. Also in the news: Medicare Advantage data transparency issues.

Study: Hospitals Charge Commercial Insurance Double That Of Medicare Advantage Plans

August 10, 2023 Morning Briefing

An analysis of published hospital pricing and insurer payment data finds that commercial insurance payers were charged more than 2 times that of Medicare Advantage. The gap was even larger for surgical procedures.

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