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CMS To End Advance-Payment Program For Those Affected By Hack

June 18, 2024 Morning Briefing

The program, launched in March in the aftermath of the Change Healthcare cyberattack, sent advance payments to providers whose operations were disrupted. CMS also announced a do-over of 2024 quality scores for Medicare Advantage plans.

CMS: 2025’s Medicare Advantage Prior Authorization Standards Are Set

April 5, 2024 Morning Briefing

Modern Healthcare says regulators will enhance Medicare Advantage “marketing, prior authorization, and network adequacy standards.” The publication also reports that higher fines are working to make more hospitals disclose pricing.

Era of ‘Free’ Covid Vaccines, Test Kits, and Treatments Is Ending. Who Will Pay the Tab Now?

By Julie Appleby February 10, 2023 KFF Health News Original

Insurers, employers, and taxpayers will all be affected as drug manufacturers move these products to the commercial market.

What the Health? From KFF Health News: Health Funding in Question in a Speaker-Less Congress

October 12, 2023 Podcast

A bitterly divided Congress managed to keep the federal government running for several more weeks, while House Republicans struggle — again — to choose a leader. Meanwhile, many people removed from state Medicaid rolls are not finding their way to Affordable Care Act insurance, and a major investigation by The Washington Post attributes the decline in U.S. life expectancy to more than covid-19 and opioids. Lauren Weber of The Washington Post, Victoria Knight of Axios, and Sarah Karlin-Smith of the Pink Sheet join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews physician-author-playwright Samuel Shem about “Our Hospital,” his new novel about the health workforce in the age of covid.

Trump Chooses Dr. Mehmet Oz To Run Medicare And Medicaid Agency

November 20, 2024 Morning Briefing

A former cardiothoracic surgeon and professor at Columbia University, Dr. Oz is better known to the public as a TV personality and has no experience running a government agency. If confirmed as the CMS administrator, he would be influential in major policies around how states run their Medicaid programs and regulations on Medicare Advantage private plans.

What the Health? From KFF Health News: Congress Kicks the (Budget) Can Down the Road. Again.

November 16, 2023 Podcast

Congress narrowly avoided a federal government shutdown for the second time in six weeks, as Democrats came to the rescue of divided House Republicans over annual spending bills that were supposed to be finished by Oct. 1. But the brinksmanship is likely to repeat itself early in 2024, when the next temporary spending patches expire. Meanwhile, a pair of investigations unveiled this week demonstrate how difficult it still is for seniors to get needed long-term and rehabilitation care. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Joanne Kenen of Johns Hopkins University and Politico Magazine join KFF Health News’ Julie Rovner to discuss these issues and more.

4.2% Medicare Pay Raise Coming To Nursing Homes In Fiscal 2025

August 1, 2024 Morning Briefing

The rate is higher than the 4.1% the Centers for Medicare and Medicaid Services proposed in March. Also in the news: Humana predicts losing a few hundred thousand Medicare Advantage members next year; Google is not renewing its contract with Amazon One Medical for staff care; and more.

Seeking to Shift Costs to Medicare, More Employers Move Retirees to Advantage Plans

By Susan Jaffe March 3, 2022 KFF Health News Original

Private and public employers are increasingly using the government’s Medicare Advantage program as an alternative to their existing retiree health plan and traditional Medicare coverage. As a result, the federal government is paying the “overwhelming majority” of medical costs, according to an industry analyst.

Morning Briefing for Thursday, November 30, 2023

November 30, 2023 Morning Briefing

Medicare Advantage, a possible Cigna-Humana merger, covid wastewater tracking, Medicaid expansion, women’s health, and more are in the news.

4 Months After Cyberattack, VA Grapples With Paying Providers

June 26, 2024 Morning Briefing

The attack hit a third-party company that manages some processes for the Department of Veterans Affairs. Officials say they’re still working to clear a backlog of payments to pharmacies and other providers. Also in the news: AI use by Medicare Advantage insurers.

AARP’s Billion-Dollar Bounty

By Fred Schulte June 6, 2022 KFF Health News Original

With its latest venture into primary care clinics, is America’s leading organization for seniors selling its trusted seal of approval?

House Passes Bill Barring Use Of QALY Metric In Federal Health Programs

February 8, 2024 Morning Briefing

The legislation would ban the use of quality-adjusted life years indexes when valuing medicines for federal health programs such as Medicaid, Medicare Advantage, and VA Health Care.

What the Health? From KFF Health News: GOP House Opens With Abortion Agenda

January 12, 2023 Podcast

Leaders of the new Republican-led U.S. House kicked off their legislative agenda with two bills supported by anti-abortion groups. While neither is likely to become law, the move demonstrates how abortion will continue to be an issue in Washington. Meanwhile, as open enrollment for the Affordable Care Act nears its end in most states, the number of Americans covered by the plans hits a new high. Margot Sanger-Katz of The New York Times, Alice Miranda Ollstein of Politico, and Sarah Karlin-Smith of the Pink Sheet join KHN’s Julie Rovner to discuss these topics and more. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too.

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.

Spotlight Falls On ‘Two-Midnight Rule’ For Medicare Patient Hospital Stays

May 16, 2024 Morning Briefing

Modern Healthcare reports on how providers and Medicare Advantage companies are reacting to the new policy that allows more patient visits to be categorized as higher-cost inpatient care. Separately, reports explain how Blackstone Equity Healthcare is lowering costs.

Morning Briefing for Tuesday, November 7, 2023

November 7, 2023 Morning Briefing

Election Day, Medicare Advantage rules, gun violence, virus surveillance, abortion law, opioids, smoking, and more are in the news.

Morning Briefing for Monday, October 23, 2023

October 23, 2023 Morning Briefing

Opioid settlements, Medicare Advantage, finding covid shots, Medicaid enrollments, AI chatbots, dementia, and more are in the news.

Medicare Pay Cuts Will Hurt Seniors’ Care, Doctors Argue

By Michael McAuliff December 20, 2022 KFF Health News Original

New reductions in Medicare payments in 2023 will drive more doctors away from accepting Medicare patients, physicians say. They are again pushing back on efforts largely designed to control government spending.

Morning Briefing for Thursday, October 19, 2023

October 19, 2023 Morning Briefing

Social Security clawbacks, maternal health, NIH nominee hearing, Medicare Advantage, Paxlovid cost, and more are in the news.

What the Health? From KFF Health News: New Flu Vax? FDA Says No Thanks

February 12, 2026 Podcast

It’s been a busy week at the FDA, with a political appointee overruling agency scientists to reject an application for a new flu vaccine. Meanwhile, anti-abortion Republicans on Capitol Hill complain the agency is dragging its feet on reviewing the abortion pill mifepristone. Jackie Fortiér of KFF Health News, Lizzy Lawrence of Stat, and Alice Miranda Ollstein of Politico join KFF Health News’ Julie Rovner to discuss these stories and more.

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