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An explosive report prepared by a SynerMed executive alleges the California firm, which oversaw care for 1.2 million patients, fabricated documents and violated state and federal regulations for years. The state says it left low-income patients on Medicaid managed care in “imminent danger.”
With the nation's opioid crisis, urine testing has become a booming business and is especially lucrative for doctors who operate their own labs, a Kaiser Health News investigation finds. And dozens of practitioners have earned "the lion’s share" of their Medicare income exclusively from urine drug screens.
At a hearing Wednesday, federal health officials pointed to billing errors, fraud and overcharges that led Medicare to overpay by staggering sums.
A new treatment for tooth decay is cheaper, quicker and less painful than getting a filling. Originally touted as a solution for kids, silver diamine fluoride is poised to become a game changer for treating cavities in older adults or those with disabilities that make oral care difficult.
Jennifer Haberkorn of the Los Angeles Times, Joanne Kenen of Politico and Kimberly Leonard of the Washington Examiner join KHN’s Julie Rovner to answer listener questions about the fate of the Affordable Care Act, “Medicare-for-all“ and how to talk about health care costs. Also, for extra credit, the panelists offer their favorite “extra credit” stories of the week.
As lawmakers look for ways to stabilize the health law marketplaces, a number of ideas — such as expanding who can “buy in” to Medicare and Medicaid or pushing young adults off their parents’ plans into the marketplaces — might come into play.
Although proponents say the policies offered by nursing homes are more attuned to patients, some report frustrations when trying to dispute care decisions.
Although the federal government has poured billions of dollars into hospitals to defray their losses from the coronavirus outbreak, new streams of fundraising have emerged — including health worker-themed beer that adds “a drop in the bucket.”
In the past eight months, Medicare officials have quietly granted the special enrollment periods to more than 15,000 Medicare Advantage members in seven states, the District of Columbia and Puerto Rico.
With stay-at-home orders in place, hospitals experimented with delivering many treatments to patients where they lived. They were a success. As society reopens, the return of old payment practices may prevent the adoption of this new, efficient model of care.
KHN readers detail their frustrations and successes as they hunt for a scarce covid-19 vaccine.
But some of those options, like special enrollment periods, are time-sensitive.
The company, which is the nation’s largest Medicare Advantage operator, denies wrongdoing and argues that the Justice Department “fundamentally misunderstands” how Medicare Advantage works.
Organized labor is divided over whether to support “Medicare for All.” Meanwhile, many of the Democratic presidential candidates seem unable to use the health issue to their advantage. Rebecca Adams of CQ Roll Call, Jennifer Haberkorn of the Los Angeles Times and Alice Miranda Ollstein of Politico join KHN’s Julie Rovner to discuss this and more. Also, for extra credit, the panelists offer their favorite health policy stories of the week they think you should read, too.
After the FDA issues a public warning about the test, one of its senior officials says point-of-care coronavirus tests can miss 20% of cases and still be considered useful. Public health experts are split.
As the coronavirus threatens the finances of thousands of hospitals, wealthy ones that can draw on millions — and even billions — of dollars in savings are in competition with near-insolvent hospitals for limited pots of financial relief.
The nation’s second-largest insurer is shrinking its presence on Obamacare exchanges and in the broader individual market in response to prevailing uncertainty. California is just the latest — and the biggest — example.
The Department of Justice is joining a whistleblower lawsuit in a fraud case against UnitedHealth in which damages could top $1 billion.
Because seniors are at higher risk of cognitive impairment, proponents say screening asymptomatic older adults is an important strategy to identify people who may be developing dementia and to improve their care. But the U.S. Preventive Services Task Force cited insufficient evidence the tests are helpful.
The good news: Life expectancy for people who make it to 65 has increased. Yet, coastal and urban people fare better than those in rural and middle America.
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