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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.

Humana Health Plan Overcharged Medicare by Nearly $200 Million, Federal Audit Finds

By Fred Schulte April 20, 2021 KFF Health News Original

Medicare Advantage company may face record penalty over alleged billing errors.

What the Health? From KFF Health News: Kennedy Cancels Vaccine Funding

August 7, 2025 Podcast

The Health and Human Services secretary is winding down nearly $500 million in mRNA research funding, citing false claims that the technology is ineffective against respiratory illnesses — and notching a victory for critics of the covid vaccines. And President Donald Trump is demanding drugmakers drop their prices, quickly, but it’s unclear how he could make them comply. Lauren Weber of The Washington Post, Sandhya Raman of CQ Roll Call, and Sarah Karlin-Smith of the Pink Sheet join KFF Health News’ Emmarie Huetteman to discuss these stories and more.

Readers Make Their Wish Lists, Checking Up on Health Care

December 16, 2025 KFF Health News Original

KFF Health News gives readers a chance to comment on a recent batch of stories.

Trump Wants Americans To Make More Babies. Critics Say His Policies Won’t Help Raise Them.

By Stephanie Armour and Amanda Seitz December 3, 2025 KFF Health News Original

The administration’s embrace of the pronatalist movement often doesn’t include support for programs traditionally associated with the health and well-being of women, children, and families.

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.

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.

Even Patients Are Shocked by the Prices Their Insurers Will Pay — And It Costs All of Us

By Elisabeth Rosenthal March 3, 2026 KFF Health News Original

Health care prices are on the rise, and patients are flummoxed that even insurance companies aren’t doing more to control costs.

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.

What the Health? From KFF Health News: Alabama’s IVF Ruling Still Making Waves

February 29, 2024 Podcast

Lawmakers in Congress and state legislatures are scrambling to react to the ruling by the Alabama Supreme Court that frozen embryos created for in vitro fertilization are legally children. Abortion opponents are divided among themselves, with some supporting full “personhood” for fertilized eggs, while others support IVF as a moral way to have children. Rachel Cohrs of Stat, Riley Griffin of Bloomberg News, and Joanne Kenen of the Johns Hopkins University schools of nursing and public health and Politico Magazine join KFF Health News’ Julie Rovner to discuss these issues and more. Also this week, Rovner interviews University of Pittsburgh law professor Greer Donley, who explains how a 150-year-old anti-vice law that’s still on the books could be used to ban abortion nationwide. Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too.

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.

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.

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.

What the Health? From KFF Health News: 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.

No Changes To Alzheimer’s Drug Restrictions Planned: CMS

February 23, 2023 Morning Briefing

Reuters reports that a request from the Alzheimer’s Association to reduce coverage limits on Alzheimer’s treatments has been turned down by the Centers for Medicare and Medicaid Services. Separately, the debt ceiling fight is being used to “fend off” changes to private Medicare Advantage plans.

UnitedHealthcare Will Ax Around 20% Of Existing Prior Authorizations

March 30, 2023 Morning Briefing

The changed policy, which will affect commercial, Medicare Advantage, and Medicaid members, will begin in the third quarter and will mean providers merely have to notify the insurer about pending care. Among other news, a debate over how to fund the 988 crisis line amid growing demand.

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.

Why Many Nonprofit (Wink, Wink) Hospitals Are Rolling in Money

By Elisabeth Rosenthal July 29, 2024 KFF Health News Original

Legal maneuvering, industry lobbying, and lax IRS oversight leave lots of room for “operating surpluses.”

‘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.

Big Health Insurers Plan Legal Battle Over Biden Medicare Advantage Audits

January 11, 2023 Morning Briefing

Stat reports that at the J.P. Morgan Healthcare Conference, Humana, Centene, and CVS Health-Aetna executives explained concerns over upcoming final rules on audits, also known as risk adjustment data validation. Meanwhile, the New York nurses strike entered a second day, among other news.

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