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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.

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.

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.

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.

Medicare Turns 50 But Big Challenges Await

By Mary Agnes Carey July 27, 2015 KFF Health News Original

Medicare provides coverage to one in six Americans, and federal officials hope to trim the increasing cost and improve how the program operates.

Despite Payment Cuts, Medicare Advantage Plan Enrollments Rise More Than 50 Percent

February 16, 2016 Morning Briefing

The trend bucks experts who predicted that the private plans would be gutted by the health law measure that cut payments to the private insurance programs. In other Obamacare news, 2016 sign-ups fall short of estimates made in 2010 and delayed tax forms are confusing consumers.

Aetna-Humana Deal Could Cause Medicare Advantage Costs To Increase: Report

January 22, 2016 Morning Briefing

The Center for American Progress found the proposed purchase of Humana by Aetna could lead to increased premium costs for seniors with these private Medicare plans. Meanwhile, California’s four largest health plans may owe the state an estimated $10 billion in back taxes — depending on the outcome of a pending legal case.

Good News, Bad News In Medicare Trustees Report

By Phil Galewitz July 23, 2015 KFF Health News Original

Trust fund solvent until 2030, but some seniors may see a big spike in Part B premiums.

Medicare Slow To Adopt Telemedicine Due To Cost Concerns

By Phil Galewitz June 23, 2015 KFF Health News Original

Less than 1 percent of beneficiaries use the technology because Congress has put tight restrictions on it.

For Hospitals, Prestige Leads To Profits

By Shefali Luthra May 2, 2016 KFF Health News Original

A new study explores why the most profitable U.S. hospitals are who they are.

Are Medicare ACOs Working? Experts Disagree

October 21, 2015 KFF Health News Original

Federal officials reported recently that in 2014 the accountable care organizations saved $411 million, but after the program paid bonuses to the successful groups, Medicare recorded a net loss of $2.6 million. So KHN asked a panel of experts to offer their views about the program.

Medicare Advantage Plans Overcharged By Millions With Diminished Chance Of Getting Caught

December 18, 2015 Morning Briefing

The Center for Public Integrity reports that CMS officials perform only 30 in-depth financial audits to recover overpayments each year, when they have the capacity for 80. Meanwhile, news outlets report on other Medicare developments such as the impact of the budget deal on the program, the continued high out-of-pocket costs for oral cancer medications and 21st Century Oncology Holdings’ $19.75 million settlement of a billing probe.

How Medicare Drug Plans Hope To Follow Private Sector Lead

By Julie Appleby March 18, 2016 KFF Health News Original

The proposal that Medicare made this month to better control prescription drug costs involves testing strategies used with some success in the private sector.

Tax Credits For Seniors’ Home Modifications Could Save States Medicaid Funding

August 24, 2016 Morning Briefing

Virginia and some other jurisdictions are offering residents tax advantages to help pay to retrofit a home, for example widening doorways to accommodate wheelchairs or adding ramps. Also, a look at how for-profit companies are moving into a Medicare program designed to keep people in their homes.

Some Dialysis Patients Give Medicare Failing Grade On Ambulance Trial

By Lisa Gillespie February 8, 2016 KFF Health News Original

A Medicare trial aimed at averting billing fraud and waste in nonemergency ambulance service in eight states is drawing complaints from patients’ families and ambulance companies.

Research Roundup: The Cadillac Tax; Patient-Centered Care; Medicare Advantage

October 30, 2015 Morning Briefing

Each week, KHN compiles a selection of recently released health policy studies and briefs.

Medicare Advantage Plan Ratings May Be Adjusted After Fairness Complaints

October 21, 2015 Morning Briefing

Elsewhere, a proposal to stave off a $54-per-month increase in Medicare premiums for some seniors could lead to a budget battle on Capitol Hill.

CMS Releases Star Ratings For 2016 Medicare Advantage Plans

October 9, 2015 Morning Briefing

Almost three out of four beneficiaries are enrolled in medical and drug coverage plans that received at least a four-star quality rating, according to the Centers for Medicare and Medicaid Services. The rankings did show a drop for some companies, especially in regard to prescription drug benefits.

Pa. High Court To Hear Expedited Appeal In UPMC-Highmark Case

September 10, 2015 Morning Briefing

At issue is a Commonwealth Court judge’s order in May that says UPMC must maintain in-network rates until 2019 for people insured by Highmark Medicare Advantage plans. UPMC canceled its Medicare Advantage contract with rival Highmark in April.

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