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Aetna Seeks To Assuage DOJ’s Anti-Competition Concerns Over Humana Merger

July 11, 2016 Morning Briefing

Company executives met with Justice Department officials on Friday to deliver assurances that they will address competitive concerns through asset sales. WellCare and Centene are among the insurers who have offered to buy its Medicare Advantage plans.

Aetna Reportedly May Sell Medicare Advantage Assets To Ease Concerns About Humana Merger

July 5, 2016 Morning Briefing

The insurance company reportedly hopes the move will help ease antitrust concerns as it seeks an acquisition of another insurer, Humana. Also, federal Medicare officials announce a new rule that will allow some companies access to claims data.

Lawsuit Alleges United Healthcare Overcharged Medicare For Advantage Plan Customers

February 17, 2017 Morning Briefing

The lawsuit, which was unsealed Thursday after a five-year investigation by the Department of Justice, suggests the company may have improperly collected “hundreds of millions” of dollars by claiming patients were sicker than they actually were.

Don’t Just Renew Your Medicare Plan. Shopping Around Can Save Money.

By Susan Jaffe October 15, 2015 KFF Health News Original

Enrollment for private Medicare Advantage and Part D drug plans begins Oct. 15 and consumer advocates urge seniors to check out prices to find the best deals.

Fueled By Health Law, ‘Concierge Medicine’ Reaches New Markets

By Shefali Luthra January 14, 2016 KFF Health News Original

Doctors, insurers and others are kick-starting experiments to broaden access to direct primary care, a service long associated with only wealthy Americans.

GAO: More Oversight Needed Over Medicare Advantage Provider Networks

By Phil Galewitz September 30, 2015 KFF Health News Original

Congressional watchdog says the government checks few health plans to ensure accurate provider listings and adequate access for seniors on Medicare Advantage.

Democratic Candidates Debate ‘Single-Payer,’ But What Does That Mean?

By Julie Rovner January 22, 2016 KFF Health News Original

The phrase often used for government-run health care means different things to different people. Here are five points to help explain the Democrats’ policy clash.

Medicare Releases Details From Review Of Advantage Plan Directories’ Accuracy

January 19, 2017 Morning Briefing

The Centers for Medicare & Medicaid Services, which earlier had given a summary that showed overall problems, provides names of companies that fared badly in the survey and other details.

Cigna CEO David Cordani: ACA Marketplace Is Still In ‘Version 1.0’

By Julie Appleby December 7, 2015 KFF Health News Original

In a recent interview, Cordani discussed the evolution of exchange health plans as well the proposed merger between Cigna and Anthem.

Seniors Who Don’t Consider Switching Drug Plans May Face Steep Price Rise

By Michelle Andrews October 20, 2015 KFF Health News Original

For beneficiaries, staying in their current plans could prove costly so advocates urge them to check out the alternatives.

Watchdog Report Sharply Criticizes Fed’s Efforts To Recoup Medicare Advantage Overcharges

May 10, 2016 Morning Briefing

The Government Accountability Office said that the Centers for Medicare & Medicaid Services has spent about $117 million on Medicare Advantage overbilling audits, but so far has recouped just $14 million. Meanwhile, some Democrats are speaking up for the Medicare Part B change in the face of intense criticism. Also, fee-for-service payments are published and health systems offset Medicare losses.

When Drug Reviewers Leave The FDA, They Often Work For Pharma

By Sydney Lupkin September 27, 2016 KFF Health News Original

Researchers examine the Food and Drug Administration’s “revolving door” regarding employees who worked on cancer and hematology drugs.

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.

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.

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