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Medicare Rejects Several Requests From Insurers For Changes In Proposed Advantage Plan Rules

August 28, 2017 Morning Briefing

Insurers sought some relief on the proposals, which are now being evaluated by the Office of Management and Budget. Meanwhile, CBS News offers some tips for consumers thinking about purchasing a Medicare Advantage plan when open enrollment begins in October.

Exodus By Puerto Rican Medical Students Deepens Island’s Doctor Drain

By Carmen Heredia Rodriguez May 1, 2017 KFF Health News Original

Interest in medical schools is high in Puerto Rico, but many students look to the U.S. mainland for residencies because of higher pay and the commonwealth’s declining economy. The migration of young talent is both a symptom and an exacerbation of the island’s medical woes.

Sign-Up Deadline Is Friday, But Some People May Get Extra Time

By Michelle Andrews December 12, 2017 KFF Health News Original

Although in most states the insurance marketplace deadline is Friday, some consumers might be entitled to a special enrollment period if their 2017 plan is being discontinued or they are from states designated by the federal government as hurricane disaster areas.

Displaced Puerto Ricans Face Obstacles Getting Health Care

By Paula Andalo November 21, 2017 KFF Health News Original

Many have complicated questions about whether their Medicaid or Medicare coverage can shift to their new homes. And for those seeking private insurance, using the ACA’s insurance marketplaces will likely be a new experience.

HHS Pick Price Made ‘Brazen’ Stock Trades While His Committee Was Under Scrutiny

By Marisa Taylor and Christina Jewett February 7, 2017 KFF Health News Original

With federal investigators bearing down on his committee, Rep. Tom Price, R-Ga., who is line to be secretary of the Department of Health and Human Services, showed little restraint in investing in health companies.

Feds Find Doctor Listings Often Wrong In Medicare Advantage Directories

By Phil Galewitz October 24, 2016 KFF Health News Original

The federal government’s first in-depth review reveals errors such as wrong addresses and incorrect phone numbers riddle many directories used by Medicare Advantage beneficiaries.

Marketing Sanctions Lifted Off Cigna

June 19, 2017 Morning Briefing

The federal sanctions barred the company from marketing and selling its Medicare Advantage policies to new beneficiaries.

Medicare Bars New ‘Seamless Conversion’ Efforts For Some Seniors

By Susan Jaffe October 28, 2016 KFF Health News Original

Some insurers have been allowed to move customers on the health law’s marketplaces into their Medicare Advantage plans when they become eligible for Medicare, but seniors complain they didn’t always know it was happening.

For Seniors, Teeth Need Care — But Insurance Coverage Is Rare

By Michelle Andrews October 25, 2016 KFF Health News Original

Traditional Medicare does not cover most dental needs and the private Medicare Advantage plans often have limited coverage, leaving most seniors struggling to pay for dental care out of pocket.

Care Suffers As More Nursing Homes Feed Money Into Corporate Webs

By Jordan Rau December 31, 2017 KFF Health News Original

Increasingly, owners of nursing homes outsource services to companies in which they also have financial interest or control. That allows the nursing homes to claim to be in the red while owners reap hidden profits.

La otra crisis de Puerto Rico: el éxodo de médicos jóvenes

By Carmen Heredia Rodriguez May 1, 2017 KFF Health News Original

Estudiar medicina es una opción popular entre los jóvenes puertorriqueños. Pero muchos graduados están yéndose, eligiendo mejores oportunidades de trabajo, a pesar de las crecientes y urgentes necesidades de salud de Puerto Rico.

Chasing Millions In Medicaid Dollars, Hospitals Buy Up Nursing Homes

By Phil Galewitz October 18, 2017 KFF Health News Original

The strategy has been used mostly in Indiana, where many county-owned hospitals purchased or leased nursing homes to take advantage of a wrinkle in Medicaid payment rules and augment federal reimbursements.

Puertorriqueños desplazados enfrentan obstáculos para tener seguro médico

By Paula Andalo November 21, 2017 KFF Health News Original

Más de 140,000 puertorriqueños llegaron a la zona central de Florida desde que el huracán María devastó la isla. En muchos casos, los planes médicos que tenían en Puerto Rico no funcionaron en el continente.

Middle-Class Earners Weigh Love And Money To Curb Obamacare Premiums

By Rachel Bluth December 4, 2017 KFF Health News Original

Ineligible for subsidies, a Tennessee woman quit her job to get an affordable health care premium. Conventional steps — such as maxing out your 401(k) contribution each year — may also do the job, financial planners say.

Dentistry Advocates Aim To Fill Medicare Gaps

By Phil Galewitz March 6, 2017 KFF Health News Original

Brushing aside a political climate that favors federal cuts in health care spending, advocates for oral health are pushing to expand Medicare to provide America’s elderly with dental benefits.

Health Care Providers Ask Congress To Expand Telemedicine Coverage In Medicare

May 17, 2017 Morning Briefing

The group is also seeking permission for Medicare Advantage plans to tailor coverage for some patients with special needs by offering services such as meal delivery for people with diabetes, rides to doctors’ appointments and home modifications. Under current law, any add-ons in Medicare Advantage have to be available to all plan members.

How To Enroll In Medicare And Avoid Costly Mistakes

By Judith Graham October 27, 2016 KFF Health News Original

Enrolling in Medicare is confusing and mind-boggling if you don’t act at the right time and avoid costly mistakes.

Medicaid Expansion Takes A Bite Out Of Medical Debt

By Alex Smith, KCUR November 17, 2017 KFF Health News Original

Medical debt is down across the country. In states that expanded Medicaid under the Affordable Care Act, the reduction is sharper.

How Pharma Companies Build An Impenetrable Fortress Of Patents To Keep Generic Competition At Bay

May 17, 2018 Morning Briefing

“One of the barriers to competition that concerns me the most is when companies game the system by taking advantage of certain rules and laws,” FDA Commissioner Scott Gottlieb has said. “They exploit loopholes in our system to delay generic entry. In these ways, they extend a drug’s monopoly beyond what Congress intended.” Meanwhile, despite any Medicare drug changes being a long shot, the pharmaceutical industry is worried.

Uncertain Fate Of Health Law Giving Health Industry Heartburn

By Julie Rovner and Chad Terhune November 21, 2016 KFF Health News Original

The effect of “repeal and replace” could have greatest consequences for hospitals. They accepted lower federal funding under the law because their uncompensated care was expected to fall as more people became insured.

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