Medicare Advantage Plans May Be Exaggerating Sicknesses, CMS Worries
October 22, 2021
Morning Briefing
Jonathan Blum, principal deputy administrator of the Centers for Medicare and Medicaid Services, said CMS was very worried about “code growth” trends. Other reports say the HHS Office of Inspector General determined Tennessee has claimed $1.1 billion uncompensated care fees improperly.
MetroHealth’s ‘Hospital In The Home’ Program Has Treated 900 Patients
February 15, 2022
Morning Briefing
Crain’s Cleveland Business reports MetroHealth’s tech-driven program to deliver high-touch care for patients in their own home has been active for nearly two years. A contract dispute that could shape future Medicare Advantage negotiations and more are also in the news.
Patient Groups Try Calling Medicare Officials Villains Over Aduhelm Ruling
January 19, 2022
Morning Briefing
Politico covers aggressive pushback from drugmakers and patient advocacy groups over the recent decision to strongly limit Medicare coverage of Alzheimer’s drug Aduhelm. Meanwhile, Axios says six big health insurers dominate the fast-growing Medicare Advantage market.
As Patients Fell Ill With Covid Inside Hospitals, Government Oversight Fell Short
By Lauren Weber Christina Jewett
Photos by Heidi de Marco
December 23, 2021
KFF Health News Original
A KHN investigation finds that hospitals with high rates of covid patients who didn’t have the diagnosis when they were admitted have rarely been held accountable due to multiple gaps in government oversight.
Be Aware: Someone Could Steal Your Medical Records and Bill You for Their Care
By Michelle Andrews
July 31, 2023
KFF Health News Original
Consumers should know that this type of fraud can happen, whether from a large-scale breach or theft of an individual’s data. The result could be thousands of dollars in medical bills.
These Appalachia Hospitals Made Big Promises to Gain a Monopoly. They’re Failing to Deliver.
By Brett Kelman Samantha Liss
September 29, 2023
KFF Health News Original
Ballad Health, the only hospital system across a large swath of Tennessee and Virginia, has fallen short of quality-of-care and charity care obligations — even as it’s sued thousands of patients for unpaid bills.
From Dr. Oz to Heart Valves: A Tiny Device Charted a Contentious Path Through the FDA
By David Hilzenrath Holly K. Hacker
July 9, 2024
KFF Health News Original
The story of MitraClip, a device Dr. Oz helped invent to treat faulty heart valves, is a cautionary tale about the science, business, and regulation of medical technology.
Pandemic Delays Federal Probe Into Medicare Advantage Health Plans
By Fred Schulte
April 8, 2020
KFF Health News Original
Government officials want to focus on fighting COVID-19 instead of recouping overcharges that run into the millions.
After People on Medicaid Die, Some States Aggressively Seek Repayment From Their Estates
By Tony Leys
March 2, 2023
KFF Health News Original
States take drastically different approaches to recovering Medicaid money from deceased participants’ estates. Demands for repayment of Medicaid spending can drain the assets a person leaves behind, depending on where they lived.
KFF Health News' 'What the Health?': The State of the Union Is … Busy
March 7, 2024
Podcast
At last, Congress is getting half of its annual spending bills across the finish line, albeit five months after the start of the fiscal year. Meanwhile, President Joe Biden delivers his annual State of the Union address, an over-the-counter birth control pill is (finally) available, and controversy erupts over new public health guidelines for covid-19 isolation. Alice Miranda Ollstein of Politico, Sarah Karlin-Smith of the Pink Sheet, and Sandhya Raman of CQ Roll Call join KFF Health News’ Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Neera Tanden, the White House domestic policy adviser, about Biden’s health agenda. Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too.
Watchdog Suggests Medicare Advantage Customers Underserved At End Of Life
July 30, 2021
Morning Briefing
A Government Accountability Office report finds that Medicare Advantage beneficiaries in their last year of life were more than twice as likely to drop their policies and enroll in traditional Medicare than other Medicare Advantage enrollees. Other Medicare news covers chronic care, racial coverage gaps and provider pay hikes.
While Inflation Takes a Toll on Seniors, Billions of Dollars in Benefits Go Unused
By Judith Graham
September 12, 2022
KFF Health News Original
With prices of necessities rising dramatically, many older Americans are having trouble making ends meet. They often don’t know that help is available from a variety of programs, and some sources of financial assistance are underused.
Countless Homebound Patients Still Wait for Covid Vaccine Despite Seniors’ Priority
By Judith Graham
February 22, 2021
KFF Health News Original
Health organizations have begun sending doctors and nurses to apartment buildings and private homes to vaccinate homebound seniors, but the efforts are slow and spotty.
Save Billions or Stick With Humira? Drug Brokers Steer Americans to the Costly Choice
By Arthur Allen
September 19, 2023
KFF Health News Original
Thousands of patients with autoimmune diseases who rely on Humira, with a list price of $6,600 a month, could get financial relief from new low-cost rivals. So far, the pharmacy benefit managers that control drug prices in America have not delivered on those savings.
An Arm and a Leg: Wrestling With a Giant: How to Dispute a Hospital Bill
By Dan Weissmann
March 13, 2023
Podcast
One listener tried to dispute a $1,300 “facility fee” with the treating hospital, his insurer, a bill-mediation service provided by his employer, and finally a debt collector. He didn’t win, but he learned valuable lessons about advocating for hospital discounts.
KFF Health News' 'What the Health?': Welcome Back, Congress. Now Get to Work.
September 7, 2023
Podcast
Congress returns from its summer recess with a long list of tasks and only a few work days to get them done. On top of the annual spending bills needed to keep the government operating, on the list are bills to renew the global HIV/AIDS program, PEPFAR, and the community health centers program. Meanwhile, over the recess, the Biden administration released the names of the first 10 drugs selected for the Medicare price negotiation program.
20 Medicare Advantage Insurers Took Lion’s Share Of Payments, Probe Finds
September 23, 2021
Morning Briefing
A Wednesday report from the HHS’s Office of Inspector General said the 20 accounted for more than half of the $9.2 billion the federal government paid for care that beneficiaries may not have needed or received in 2016, Modern Healthcare reports.
Americans Increasingly Dependent On Government Aid, Research Shows
September 30, 2024
Morning Briefing
An exclusive Wall Street Journal report shows how government support is taking an evermore central role in many Americans’ lives, with programs like Social Security, Medicare, and Medicaid at the core. Separately, CMS said Medicare Part D and Advantage premiums will decline next year.
Missouri’s Medicaid Expansion Must Begin Immediately, Judge Rules
August 11, 2021
Morning Briefing
Cole County Circuit Judge Jon Beetem rejected a request for at least a two-month delay. Other news is on the growth of Medicare Advantage and Medicare coverage for seniors.
Discretamente, Biden está transformando la red de seguridad de Medicaid
By Noam N. Levey Phil Galewitz
June 24, 2021
KFF Health News Original
Los esfuerzos de Biden, que han sido eclipsados en gran medida por otras iniciativas económicas y de salud, representan un cambio abrupto en contra de todo lo que la administración Trump hizo para reducir el programa.
