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Insurers Say Medicare Advantage Saves Money. Experts Say No

September 26, 2022 Morning Briefing

Stat says while the insurance industry is still trying to convince the public Medicare Advantage saves taxpayer money, experts point to federal data proving the opposite. Also: CommonSpirit Health’s loss of $2 billion, a hospital chain making money off a poor neighborhood, more.

The Supreme Court Just Limited Federal Power. Health Care Is Feeling the Shockwaves.

By Stephanie Armour July 1, 2024 KFF Health News Original

A Supreme Court ruling restricting federal power will likely have seismic ramifications for health policy. A flood of litigation — with plaintiffs like small businesses, drugmakers, and hospitals challenging regulations they say are too expensive or burdensome and not authorized by law — could leave the country with a patchwork of disparate health regulations.

¿Por qué Medicare no paga por las pruebas caseras para covid?

By Michelle Andrews January 24, 2022 KFF Health News Original

Las mismas leyes del programa para los adultos mayores previenen que puedan comprar medicamentos de venta libre y obtener este tipo de pruebas sin una orden médica.

House Speaker Says Medicare Cuts Off The Table In Debt Ceiling Negotiations

January 27, 2023 Morning Briefing

House Speaker Kevin McCarthy has assured that Medicare and Social Security will no longer be Republican targets in talks to strike a debt ceiling deal. In related news, a Republican study group eyes potential Medicare changes. And secret audits found millions in Medicare Advantage plan overpayments.

Despite Seniors’ Strong Desire to Age in Place, the Village Model Remains a Boutique Option

By Judith Graham March 14, 2022 KFF Health News Original

Membership-based villages help arrange services for seniors — such as handyman help or transportation to appointments — and provide social connections through classes, leisure opportunities, or community events. Despite great promise, they have been slow to expand because of difficulties raising funding and keeping people interested.

Humana Reveals Plans To Exit Employer-Based Insurance Market

February 24, 2023 Morning Briefing

News outlets report on a new strategy from health insurer Humana: it will take up to two years to exit the employer-based insurance business, and instead focus on government-backed programs like Medicare Advantage. Amazon, SimpliFed, DaVita, Teledoc, and more are also in the news.

3 More Top Medical Schools Withdraw From US News Rankings

January 25, 2023 Morning Briefing

Following Harvard University, three more top-10 medical schools — at the University of Pennsylvania and at Columbia and Stanford universities — have now also withdrawn their data from the U.S. News list. Audits of Medicare Advantage insurers, clawbacks, and price transparency are also in the news.

Harris-Walz Ticket Sharpens Contrast With Trump-Vance on Health Care

By Stephanie Armour August 19, 2024 KFF Health News Original

As Democrats convene in Chicago to make official their presidential and vice presidential nominees, Vice President Kamala Harris and Minnesota Gov. Tim Walz together are raising the prominence of health care as a 2024 election issue.

West Virginia Sen. Manchin Takes the Teeth Out of Democrats’ Plan for Seniors’ Dental Care

By Phil Galewitz December 10, 2021 KFF Health News Original

In West Virginia, older residents often go without dental care, and a quarter of people 65 and older have no natural teeth, the highest rate of any state in the country. But a powerful senator from West Virginia, Joe Manchin, has rebuffed efforts to add a dental benefit to Medicare.

Bright Health Pulls Insurance, Medicare Advantage Plans From 9 States

October 12, 2022 Morning Briefing

The insurtech company says it will only operate in Florida and California in order to reduce costs and settle medical liabilities.

House Passes Medicare Advantage Reform Bill; It Now Heads To Senate

September 15, 2022 Morning Briefing

The Improving Seniors’ Timely Access to Care Act strives to make it easier for seniors to get care and to modernize the process of prior authorizations. For example, the current process often still requires using fax machines to send documents to insurance companies.

CMS Eyes Mandating Electronic Prior Authorization Systems By 2026

December 7, 2022 Morning Briefing

The proposed rule calls for Medicare Advantage, Medicaid, and some other health insurance exchanges to update prior authorization processes. Among the potential mandates are for payers to respond to “urgent” requests within 72 hours, justify denials, and report decisions.

Elevance Health Must Face $100 Million Medicare Advantage Fraud Case

October 5, 2022 Morning Briefing

Judge Andrew Carter ruled Elevance, formerly Anthem, must face a Department of Justice lawsuit alleging the insurer submitted fraudulent patient information. In other news, a Bay Area hospital is sued over a $6,000 urine test, and John Muir Health is sued for allegedly overcharging patients.

FTC, Indiana Residents Pressure State To Block Hospital Merger

By Samantha Liss November 19, 2024 KFF Health News Original

Hundreds of people and the Federal Trade Commission weighed in on a proposed hospital merger in Terre Haute, Indiana, with most arguing that the creation of a monopoly would increase costs and worsen patient care.

Biden Leans Into Health Care, Asking Voters To Trust Him Over Trump

By Phil Galewitz May 21, 2024 KFF Health News Original

President Joe Biden’s new health care ad draws on the Affordable Care Act’s popularity among independent voters and alludes to his edge over Trump on health issues.

KFF Health News' 'What the Health?': Underinsured Is the New Uninsured

September 14, 2023 Podcast

The percentage of working-age adults with health insurance went up and the uninsured rate dropped last year, the U.S. Census Bureau reported this week. There isn’t much suspense about which way the uninsured rate is now trending, as states continue efforts to strip ineligible beneficiaries from their Medicaid rolls. But is the focus on the uninsured obscuring the struggles of the underinsured? Margot Sanger-Katz of The New York Times, Sarah Karlin-Smith of the Pink Sheet, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico join KFF Health News’ Emmarie Huetteman to discuss these issues and more.

Centene Showers Politicians With Millions as It Courts Contracts and Settles Overbilling Allegations

By Samantha Young and Andy Miller and Rebecca Grapevine November 4, 2022 KFF Health News Original

Centene, the largest Medicaid managed-care company in the U.S., has thrown more than $26.9 million at political campaigns across the country since 2015, especially focused on states where it is wooing Medicaid contracts and settling accusations that it overbilled taxpayers. Among its tactics: Centene is skirting contribution limits by giving to candidates through its many subsidiaries.

Consejos para inscribirse bien en Medicare durante la complicada inscripción abierta

By Bernard J. Wolfson November 24, 2020 KFF Health News Original

Medicare se reduce fundamentalmente a dos alternativas: la tarifa por servicio del Medicare Tradicional o el enfoque de atención administrada de Medicare Advantage.

Connecticut Expands Medicaid To Children Of All Immigrants

January 10, 2023 Morning Briefing

Meanwhile, in New York City, officials defended legislation designed to charge municipal retirees who don’t opt into the Medicare Advantage plan for coverage. Other news from across the country covers covid deaths in Orange County, rural Latinx violence survivors, marijuana sales in Connecticut, and more.

Paying Billions for Controversial Alzheimer’s Drug? How About Funding This Instead?

By Judith Graham July 6, 2021 KFF Health News Original

Aduhelm, approved by the Food and Drug Administration last month despite questions about its efficacy, could be prescribed to at least 1 million patients a year, for a price tag of about $56 billion. Experts suggest there might be better ways to spend that money.

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