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Final Medicare Advantage Rates Involve Variety Of Compromises

April 8, 2016 Morning Briefing

Analysts say the new rates don’t represent a loss or a gain for industry — but rather a mixed bag.

Final Rule Provides Slight Increase In Medicare Advantage Payments

April 5, 2016 Morning Briefing

The payment amount decision, which came after heavy lobbying, was a bit lower than the administration initially suggested. On another part of the rule, however, the administration delayed efforts to cut payments to employer-sponsored Medicare Advantage plans.

Study: Brand-Name Drugs’ High Copays Soak Medicare Part D Patients

By Rachel Bluth July 6, 2016 KFF Health News Original

A study in Health Affairs finds Medicare Part D beneficiaries were charged copays averaging 10.5 times more for Crestor and Nexium than generic drugs would have cost them.

Venture Capital Firms, Former UnitedHealthcare CEO Set Up New Insurance Company

April 7, 2016 Morning Briefing

The startup is planning to compete in the health law’s insurance marketplaces and eventually Medicare Advantage. Also, officials have announced increases in premiums for federal workers’ long-term care insurance.

Viewpoints: Research Rules Could Block Cancer ‘Moonshot’; Medicare Advantage’s ‘Disadvantage’ For Sicker Patients

April 5, 2016 Morning Briefing

A selection of opinions from around the country.

Fewer Medicare-Subsidized Drug Plans Means Less Choice For Low-Income Seniors

By Susan Jaffe November 23, 2015 KFF Health News Original

The number of Medicare plans that cover medications with a subsidy provided for low-income beneficiaries is declining in 2016 by 20 percent.

Medicare Payment Lobbying War Heats Up As More Voices Join The Fight

March 18, 2016 Morning Briefing

The campaigns center around a proposed 1.35 percent boost to Medicare Advantage. Kaiser Health News looks at how the Obama administration is trying to borrow ideas from the private sector with its Medicare plan, Medicare beneficiaries could face higher out-of-pocket drug costs as a result of the trend toward coinsurance rather than co-payments, and Rep. Pat Tiberi, R-Ohio, is urging his fellow lawmakers to consider changes to the Medicare Advantage program.

Health Systems Dipping Into The Business Of Selling Insurance

By Michelle Andrews November 10, 2015 KFF Health News Original

These plans, which still are a minority in the marketplaces, can help drive consumers to use the system’s hospitals and doctors, but some also offer competitive prices.

Viewpoints: Medicare Advantage And The Bigger Issue Of Entitlements; Little Sisters Of The Poor At The Supreme Court

March 21, 2016 Morning Briefing

A selection of opinions from around the country.

Federal Officials Propose Small Rise In Medicare Advantage Rates

February 22, 2016 Morning Briefing

The Centers for Medicare and Medicaid Services has proposed an average 1.35 percent increase in the rate the government pays private Medicare Advantage plans for 2017.

As Medicare Stifles PSA Testing Penalties, It Signals Interest In Reviving The Issue Later

March 29, 2016 Morning Briefing

The Center for Medicare & Medicaid Services says in its statement that it will continue to solicit input “to determine whether a restructured, appropriate-use PSA measure should be developed.” Also, a look at new efforts by the agency to make sure beneficiaries in Medicare Advantage plans can keep their doctors.

Colon Cancer Screening: Five Things To Know

By Julie Appleby June 24, 2016 KFF Health News Original

The U.S Preventive Services Task Force recently expanded the list of approved colorectal cancer screening tests. Here’s a primer on these various tests and how they might be covered now and in the future by health insurance.

Catastrophic Insurance Could Help With Long-Term Care Expenses: Studies

By Michelle Andrews July 1, 2016 KFF Health News Original

Urban Institute researchers examine how such a plan could work and whether it would be better to make payments when people first need care or after they have used up much of their own money instead.

Readers Ask About Concierge Medicine And Medicare; Insulin Costs And The Doughnut Hole

By Michelle Andrews September 8, 2015 KFF Health News Original

KHN consumer columnist Michelle Andrews answers questions about Medicare beneficiaries’ costs associated with doctors who have concierge medicine practices, insulin pumps and respite care.

CMS Proposal Would Cut Payments To Medicare Advantage Plans Sponsored By Employers

February 23, 2016 Morning Briefing

The proposal would change the bidding process for plans sponsored by employers and unions for retirees. Meanwhile, The Associated Press examines how the Centers for Medicare & Medicaid Services’ favorable assessment of factors affecting rates is playing out with other Medicare Advantage plans. In other marketplace news, a group calls for the creation of long-term care insurance plans similar to Medicare, CVS health says it toned down its prescription drug spending, and the new leader at Zenefits tries to rein in the rambunctious culture at the startup.

Medicare Policy Preserves Cigna Bonuses As Insurer Fixes Plan Failures

March 11, 2016 Morning Briefing

Despite sanctions against Cigna for its mismanaged Medicare Advantage plans, a quietly announced revision in Medicare policy will allow the insurer to keep hundreds of millions of dollars in bonus payments. The change by the Centers for Medicare & Medicaid Services drove up both Cigna and Anthem stocks.

Medicaid, Private Insurers Begin To Lift Curbs On Pricey Hepatitis C Drugs

By Judith Graham July 5, 2016 KFF Health News Original

Over the past few months, Massachusetts, Florida, New York, Delaware and Washington have lifted restrictions on the expensive medications, and private insurers around the country are also making the changes.

UnitedHealthcare Sues HHS Over Medicare Advantage Overpayment Rule

February 4, 2016 Morning Briefing

The 41 UnitedHealth Group companies say the regulation will result in underpayment to insurers. In other news, the administration nears its goal for revamping the way Medicare providers are paid.

‘Widespread And Systemic Failures’ Cited In Cigna Medicare Advantage Suspension

January 25, 2016 Morning Briefing

The Centers for Medicare & Medicaid Services said Cigna did not handle complaints and grievances from patients properly. The suspension will not affect those already enrolled.

Feds Urge State Medicaid Programs To Encourage Long-Acting Contraceptives

By Michelle Andrews June 16, 2016 KFF Health News Original

Medicaid spends billions on unintended pregnancies, and federal officials say better use of long-acting contraceptives, such as IUDs, offer advantages for women and are cost-effective.

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