Feds Settle Huge Whistleblower Suit Over Medicare Advantage Fraud
A DaVita subsidiary will pay $270 million over allegations that it cheated the federal government for years.
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It’s Open Enrollment. Here’s What You Need to Know
For Californians who are buying their own insurance, enrollment in 2021 health plans runs through Jan. 31.
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New Medicare Advantage Tool To Lower Drug Prices Puts Crimp In Patients’ Choices
Federal officials are allowing the private insurance plans to use “step therapy” for drugs administered by doctors. In step therapy, patients must first use cheaper drugs to see if they work before receiving more expensive options.
By Susan Jaffe -
Furor Erupts: Billions Going To Hospitals Based On Medicare Billings, Not COVID-19
In the first round of emergency relief, some states will get more than $300,000 per COVID-19 patient, while hard-hit New York gets just $12,000 per patient.
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Technology Divide Between Senior ‘Haves’ and ‘Have-Nots’ Roils Pandemic Response
Older adults with the ability to use technology have more access to virtual social interactions and telehealth services, and more opportunities to secure essential supplies online. Those who don’t know how to use it or can’t afford it are at greater risk of social isolation, forgoing medical care and being without food or other necessary items.
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Dental Shock: Six Pulled Teeth And One Unexpected Bill
One woman's experience with the high cost of dental care and confusing Medicare coverage offers a teachable moment for other consumers. Her small church took up a collection, but the surprise bill — four times what she expected to pay — was sent to collections.
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KHN’s ‘What the Health?’: Biden Declares the Pandemic ‘Over’
President Joe Biden, in an interview with CBS’ “60 Minutes,” declared the covid-19 pandemic “over,” stoking confusion for members of his administration trying to persuade Congress to provide more funding to fight the virus and the public to get the latest boosters. Meanwhile, concerns about a return of medical inflation is helping boost insurance premiums even as private companies race to get their piece of the health pie. Anna Edney of Bloomberg News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, and Lauren Weber of KHN join KHN’s Julie Rovner to discuss these issues and more. Also, for extra credit, the panelists suggest their favorite health policy stories they think you should read, too.
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Democrats Seek To Spotlight Rising Health Costs by Forcing Vote on Trump Regulation
Congressional Democrats are seeking to overturn a Trump administration rule they say will hamper Obamacare coverage. Whether they win or lose any floor vote, they’ll likely use it in campaign messaging ahead of the midterms.
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Democratic Super PAC Uses Familiar Political Play To Hit Trump On Medicare
This is a tactic that we’ve seen before.
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Coronavirus Fuels Explosive Growth In Telehealth ― And Concern About Fraud
“Unscrupulous providers” could take advantage of the boom in treatment delivered via voice or video calls.
By Fred Schulte -
That Discount at the Pharmacy Counter May Pack Hidden Costs
The new TrumpRx program relies partly on connecting consumers with discount coupons offered by drugmakers. For insured patients, though, using a coupon can prove dicey.
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New Medicaid Work Rules Likely To Hit Middle-Aged Adults Hard
Republicans have said new rules requiring many Medicaid participants to work 80 hours a month will pinpoint unemployed young people who should have jobs. Policy researchers say the rules are more likely to disrupt coverage for middle-aged adults, harming their physical and financial health.
By Samantha Liss and Sam Whitehead -
When It Comes to Health Insurance, Federal Dollars Support More Than ACA Plans
Questions of fairness came up in last year’s congressional debate about extending Obamacare’s enhanced subsidies. Critics wondered why the federal government should underwrite coverage costs for people with ACA coverage. In truth, though, almost all health insurance in the U.S. comes with some federal help.
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In Mississippi, Medicaid Coverage of Weight Loss Drugs Fails To Catch On
In Mississippi, a state with one of the highest obesity rates in the nation, Medicaid covers weight loss drugs, but few enrollees have signed up for the benefit.
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Medicare Advantage Plans Cleared To Go Beyond Medical Coverage — Even Groceries
Under new federal rules unveiled this week, these privately run alternatives to traditional Medicare might provide air conditioners, rides to medical appointments and home-delivered meals.
By Susan Jaffe -
As Medicare Enrollment Nears, Popular Price Comparison Tool Is Missing
For more than a decade, customers used the online plan finder to compare dozens of policies. Yet after a redesign of the website, the search results no longer list which plan offers a customer the best value. Federal officials say it will be fixed before enrollment begins next week.
By Susan Jaffe -
Whistleblower Alleges Medicare Fraud At Iconic Seattle-Based Health Plan
A lawsuit against Group Health surfaces as the White House promotes Medicare Advantage for seniors.
By Fred Schulte -
An Age-Old Fear Grows More Common: ‘I’m Going To Die Alone’
As families fracture, people are living longer and are more likely to find themselves without close relatives or friends at the end of their lives.
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Needy Patients ‘Caught In The Middle’ As Insurance Titan Drops Doctors
UnitedHealthcare is dropping hundreds of physicians from its New Jersey Medicaid network, separating patients from longtime doctors. Physicians charge the insurer is using its market power to shift business to practices it controls.
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Website Errors Raise Calls For Medicare To Be Flexible With Seniors’ Enrollment
Members of Congress and others complain Medicare’s revamped Plan Finder had problems. Federal officials say they can help consumers who got bad information change their plans next year. But details about how switching will work are yet to come.
By Susan Jaffe