Medicare Advantage Enrollment Reaches 31 Million Though Is Slowing
February 22, 2023
Morning Briefing
In an analysis by the Chartis Group, enrollment in Medicare Advantage 2023 plans is up 5.5%. Last year’s signups grew 9% over the previous year. Other news relates to inpatient claim denials, Medicare drug pricing negotiations, and more.
Cyberattack Has Prolonged Impact On Hospital System In Several States
August 21, 2023
Morning Briefing
Prospect Medical Holdings is experiencing outages of key computer systems more than two weeks after a cyberattack. Among other news: Mayo Clinic is continuing its expansion; Axios says rural hospitals are experiencing a “squeeze” from Medicare Advantage; and more.
Morning Briefing for Tuesday, January 31, 2023
January 31, 2023
Morning Briefing
Today’s roundup covers the covid emergency end, Medicare Advantage overpayments, birth control, health care expenses, birth rate, and more.
Why Medicare Doesn’t Pay for Rapid At-Home Covid Tests
By Michelle Andrews
January 24, 2022
KFF Health News Original
The laws governing Medicare don’t provide coverage for self-administered diagnostic tests, which is precisely what the rapid antigen tests are and why they are an important tool for containing the pandemic.
PBMs Placed In The Crosshairs
May 18, 2023
Morning Briefing
While a House subcommittee advances a bill to make pharmacy benefit managers’ business more transparent, the FTC widens its probe into their impact on drug prices. Separately, some senators are probing Medicare Advantage plans.
CMS Eases Expected 2024 Payment Rate Cut To Medicare Advantage Insurers
April 3, 2023
Morning Briefing
Medicare Advantage providers face a 1.12% average cut in next year’s reimbursement rates, the Centers for Medicare and Medicaid Services announced Friday — lower after intense industry lobbying than the 2.3% drop regulators had previously proposed. Additional changes aimed at combatting overbilling by providers will be phased in over a 3-year period.
CMS Sets Tougher Penalties For Improper Medicare Advantage Charges
January 31, 2023
Morning Briefing
The Centers for Medicare and Medicaid Services estimates that it could claw back $4.7 billion over 10 years from pending audits of private Medicare Advantage insurers’ charges. The companies didn’t get the leniency they sought for diagnostic errors, which could set up court challenges. Insurers did a major reprieve from returning overpayments from 2011 to 2017.
KFF Health News' 'What the Health?': SCOTUS Rejects Abortion Pill Challenge — For Now
June 13, 2024
Podcast
The Supreme Court has dismissed a challenge to the FDA’s approval of the abortion pill mifepristone, ruling unanimously that the anti-abortion doctor group that filed the suit lacked standing. But abortion opponents are expected to pursue other strategies to ban or restrict the medication. Meanwhile, the Biden administration moves to stop the inclusion of medical debt on individual credit reports, and former President Donald Trump tries to claim credit for $35 insulin. Anna Edney of Bloomberg News, Rachana Pradhan of KFF Health News, and Emmarie Huetteman of KFF Health News join KFF Health News chief Washington correspondent Julie Rovner to discuss these stories and more. Also this week, Rovner interviews KFF president and CEO Drew Altman about KFF’s new “Health Policy 101” primer.
Medicare Advantage Insurers Boosting Marketing Efforts
November 9, 2022
Morning Briefing
A report in Modern Healthcare says that insurers are stepping up their marketing to attract more enrollment. Separately, Oscar Health has “all but abandoned” that market after attracting too few policyholders. USA Today explains why private Medicare plans are set to pass traditional ones.
Having Private Medicare Doesn’t Mean It’s Easy To Find A Psychiatrist: Study
July 6, 2023
Morning Briefing
More than half of the counties in a new study lacked even a single psychiatrist participating in a Medicare Advantage plan, The New York Times reports. Meanwhile, Eli Lilly is now the world’s biggest health care company by market value, beating UnitedHealth.
Morning Briefing for Tuesday, December 13, 2022
December 13, 2022
Morning Briefing
Tuesday’s roundup covers covid vaccines, Medicare Advantage plans, diabetes, misinformation, opioids, abortion law, screen time, and more.
KFF Health News' 'What the Health?': The Crisis Is Officially Ending, but Covid Confusion Lives On
May 11, 2023
Podcast
The public health emergency declaration for covid-19 ends May 11, ushering in major changes in how Americans can access and pay for the vaccines, treatments, and tests particular to the culprit coronavirus. But not everyone will experience the same changes, creating a confusing patchwork of coverage — not unlike health coverage for other diseases. Meanwhile, outside advisers to the FDA formally recommended allowing a birth control pill to be sold without a prescription. If the FDA follows the recommendation, it would represent the first over-the-counter form of hormonal contraception. Margot Sanger-Katz of The New York Times, Tami Luhby of CNN, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico join KFF Health News’ 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.
Medicare Stumbles Managing a Costly Problem — Chronic Illness
By Phil Galewitz
April 24, 2024
KFF Health News Original
Nearly a decade ago, Medicare launched a program to help the two-thirds of beneficiaries with chronic conditions by paying their doctors an additional monthly fee to coordinate their care. The strategy has largely failed to live up to its potential; only about 4 percent of potentially eligible beneficiaries in the traditional Medicare program are enrolled, […]
KHN’s ‘What the Health?’: Booster Time
August 19, 2021
KFF Health News Original
As the delta variant continues to spread around the U.S., the Biden administration is taking steps to authorize covid vaccine boosters, require nursing home workers to be vaccinated and protect school officials who want to require masks despite state laws banning those mandates. Meanwhile, the U.S. House is returning from its summer break early to start work on its giant budget bill, which includes a long list of health policy changes. Alice Miranda Ollstein of Politico, Margot Sanger-Katz of The New York Times and Kimberly Leonard of Business Insider join KHN’s Julie Rovner to discuss these issues and more.
Morning Briefing for Thursday, December 15, 2022
December 15, 2022
Morning Briefing
Thursday’s roundup covers Medicare Advantage, free covid tests, 2002 U.S. deaths, rising health costs, overdoses, mental health, and more.
Billing Arbitration Comes To An End After Changes To No Surprises Act
August 8, 2023
Morning Briefing
Last week, a court ruling saw parts of the surprise billing law vacated, and this has now resulted in the federal government stopping processing payment disputes between providers and insurers over out-of-network bills, Modern Healthcare reports. Axios notes insurers sometimes pay double for the same procedure versus Medicare Advantage prices.
‘That’s Just Part of Aging’: Long Covid Symptoms Are Often Overlooked in Seniors
By Judith Graham
May 18, 2022
KFF Health News Original
Millions of older adults are grappling with long covid, yet the impact on them has received little attention even though research suggests seniors are more likely to develop the poorly understood condition than younger or middle-aged adults.
CMS Takes Aim At Growing Problem Of Misleading Medicare Advantage Ads
December 15, 2022
Morning Briefing
The Centers for Medicare and Medicaid Services proposed a rule to ban some deceitful advertising by Medicare Advantage plans that use confusing imagery or language or don’t name the health insurance plan’s name. The growing number of such ads have led people to sign up for plans that don’t cover their doctors or prescriptions.
Lobbyists In ‘Frenzy’ Over White House Plan To Target Medicare Fraud
March 23, 2023
Morning Briefing
The New York Times explains a furor among Washington lobbyists over the Biden administration’s plans to cut Medicare fraud by “billions,” including efforts to influence public opinion. The Nevada Independent notes Medicare Advantage may be a marquee issue in the state’s 2024 Senate race.
Centene’s Medicare Advantage Quality Scores Missed Their Targets
October 26, 2022
Morning Briefing
The scores were worse than executives expected. Modern Healthcare reports that the insurer is hiring a chief quality officer as a result. Separately, Cigna’s Express Scripts reportedly won Centene’s pharmacy benefit manager contract.
