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Sen. Grassley Demands Scrutiny Of Medicare Advantage Plans

By Fred Schulte April 18, 2017 KFF Health News Original

The powerful chairman of the Senate Judiciary Committee wants the Centers for Medicare and Medicaid Services to explain $125 million in overcharges by insurers.

5 Outside-The-Box Ideas For Fixing The Individual Insurance Market

By Julie Rovner August 30, 2017 KFF Health News Original

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.

Must-Reads Of The Week From Brianna Labuskes

By Brianna Labuskes June 8, 2018 KFF Health News Original

KHN’s newsletter editor, Brianna Labuskes, wades through hundreds of health articles from the week so you don’t have to.

1.84 Percent Rate Hike Proposed For Medicare Advantage Plans In 2019

February 2, 2018 Morning Briefing

The increase in what the federal government pays the plans was near to what analysts had expected.

Medicare Directories Have Lots Of Errors, But Where The Blame Should Fall Isn’t Quite Clear Cut

February 1, 2018 Morning Briefing

Data accuracy depends on both doctors and health plans, an AHIP official said. Medicare Advantage plans depend on doctors to submit accurate and up-to-date information. Will a new review help?

CMS Wants To Adjust Payments For Medicare Advantage Plans

January 3, 2018 Morning Briefing

Under the proposed changes, risk scores used to set payments would take into account certain diagnoses of mental health disorders, substance abuse disorders and chronic kidney disease. Meanwhile, the Department of Health and Human Services has finalized a rule that offers providers and payers more flexibility to share substance abuse patients’ data.

Having Buyer’s Remorse Over Medicare Advantage Plan? You Can Still Switch Back

January 4, 2018 Morning Briefing

Medicare Advantage Disenrollment Period, which is open until Feb. 14, allows people enrolled in an Advantage plan for 2018 to switch to original Medicare. Meanwhile, in other Medicare news, the Centers for Medicare & Medicaid Services will start reviewing Advantage networks on three-year cycles.

Aetna’s Leadership Remains Mum On CVS Talks, But Posts Spike In Q3 Profit

November 1, 2017 Morning Briefing

The company touted growth in its Medicare Advantage enrollment.

Drug Trade Group Quietly Spends ‘Dark Money’ To Sway Policy And Voters

By Jay Hancock July 30, 2018 KFF Health News Original

Grants by top pharma group to lightly regulated, politically active nonprofits dwarf its conventional campaign spending.

Justice Department Joins Lawsuit Alleging Massive Medicare Fraud By UnitedHealth

By Fred Schulte March 28, 2017 KFF Health News Original

The Department of Justice is joining a whistleblower lawsuit in a fraud case against UnitedHealth in which damages could top $1 billion.

Gobierno se une a demanda en contra de UnitedHealth que alega fraude masivo al Medicare

By Fred Schulte March 28, 2017 KFF Health News Original

El Departamento de Justicia se ha unido a la demanda de un denunciante de California que acusa al gigante de seguros UnitedHealth Group de fraude en sus populares planes de salud de Medicare Advantage.

Anthem’s Retreat Leaves Californians With Fewer Choices, More Worries

By Pauline Bartolone and Anna Gorman and Chad Terhune August 2, 2017 KFF Health News Original

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.

4 New Ways You Can Avoid Fines For Not Having Health Insurance

By Michelle Andrews April 24, 2018 KFF Health News Original

Among changes by the Trump administration, new rules protect consumers living in areas with only one marketplace plan as well as those who oppose abortion and can’t find a plan that doesn’t cover the procedure.

Refusing To Work For Medicaid May Not Translate To Subsidies For ACA Plan

By Michelle Andrews February 27, 2018 KFF Health News Original

In states that are instituting work requirements for Medicaid coverage, refusing to get a job will not likely make you eligible for subsidies to buy a marketplace plan.

Don’t Get Tripped Up By The IRS Tweak To Health Savings Accounts

By Michelle Andrews April 3, 2018 KFF Health News Original

A new federal calculation reduces by $50 the amount a family can put aside in 2018 in these accounts to pay medical bills. Anyone who has already funded the account at a higher level will need to adjust or deal with the tax consequences next year.

Some Tips To Help Decide Whether Popular Medicare Advantage Plans Are Right For You

October 19, 2017 Morning Briefing

These private insurance plan take the place of traditional Medicare and vary in coverage and cost.

Medicare Advantage Plans’ Star Ratings Shows Little Change In Quality Over Past Year

October 12, 2017 Morning Briefing

Although the number of these plans earning four stars or better have fallen slightly, more beneficiaries are signing up for the higher performing plans.

21 Medicare Health Plans Warned To Fix Provider Directory Errors

By Phil Galewitz and Susan Jaffe January 18, 2017 KFF Health News Original

Federal officials release names of insurers who ranked poorly in a recent review of their online directories’ accuracy.

Drug Coverage Denied By Medicare? How Seniors Can Fight Back

By Judith Graham May 4, 2017 KFF Health News Original

Senior citizens have to be patient and keep close records to appeal when Medicare plans refuse to cover their medicines.

Parsing Health Policies And Politics: Examining The Alexander-Murray Obamacare ‘Fix’; Why Does It Have To Be So Difficult?

October 19, 2017 Morning Briefing

Opinion writers offer a variety of takes on the deal announced this week by Sen. Lamar Alexander (R-Tenn.) and Sen. Patty Murray (D-Wash.) as well as what it can and cannot accomplish. They also take a tough inventory of the politics in play and examine other health policy issues, such as Medicare Advantage networks and the status of the Children’s Health Insurance Program reauthorization.

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