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State Highlights: Mass. Eligibility Review Results In Removal Of Thousands From Medicaid Program; Medicare Advantage Developments In Colo., N.C.

July 22, 2015 Morning Briefing

Health care stories are reported from Massachusetts, Colorado, North Carolina, California, Minnesota, South Carolina and Kansas.

How One Home Health Agency Earned Five Stars

By Michael Tomsic, WFAE September 18, 2015 KFF Health News Original

In North Carolina, Brookdale Home Health Charlotte was one of just two agencies out of the state’s 172 to earn the maximum five stars from the federal government.

Most Californians On Insurance Exchange Are Sticking With Last Year’s Plan

By Jenny Gold January 29, 2015 KFF Health News Original

In California, the vast majority of people renewing health insurance coverage in the state’s exchange did not switch health plans, and instead are sticking with the one they selected last year.

Humana Explores Possible Sale As Health Insurance Marketplace Changes

June 1, 2015 Morning Briefing

News outlets report that Humana’s presence in Medicare Advantage program makes it a prime target for acquisition. And, as reports emerged about its possible sale, the insurer’s stock soared.

What To Know About Medicare’s Enrollment Period

By Mary Agnes Carey and Julie Rovner November 13, 2014 KFF Health News Original

Though not a part of the health law’s open enrollment period, Medicare’s enrollment period runs during some of the same time period. Changes to Medicare advantage and the so-called Medicare prescription drug “doughnut hole” are taking center stage.

DaVita To Pay $450M Settlement For False Claims, While Probed About Coding

June 25, 2015 Morning Briefing

The largest U.S. supplier of dialysis services agreed to the settlement to resolve claims that it knowingly created unnecessary waste in administering the drugs Zemplar and Venofer to dialysis patients, and then billed the federal government. It is also being investigated for how the company codes for Medicare Advantage patients.

A Third Of Ga. Pediatricians Join Together To Form Network To Improve Care

By Andy Miller, Georgia Health News September 1, 2015 KFF Health News Original

The new physician-led network will allow pediatricians to improve care for Georgia children by sharing best practice standards and expand their billing options for insurance, advocates say.

Humana Enters ‘Quiet Period’ Amid Sale Rumors

June 9, 2015 Morning Briefing

The publicly traded Medicare Advantage coverage provider announced the move in an SEC filing. The company refused to comment on merger speculation, which increased when Humana also pulled out of a large health care conference.

Feds Paid Too Much For Nearly Half Of UnitedHealth’s Medicare Advantage Patients, Audit Says

June 17, 2015 Morning Briefing

Three years of confidential negotiations between the insurer and the federal government were recently released in an audit. Elsewhere, N.J. Sen. Robert Menendez loses his bid to move his trial over corruption charges from his home state to Washington, D.C.

GOP Chairmen Offer Alternative To Health Law

By Mary Agnes Carey February 5, 2015 KFF Health News Original

Sens. Orrin Hatch and Richard Burr join with Rep. Fred Upton to renew a proposal to repeal the health law but preserve some tax credits for insurance and cuts to some Medicare providers.

HHS Pledges To Quicken Pace Toward Quality-Based Medicare Payments

By Jordan Rau January 26, 2015 KFF Health News Original

As part of their effort to improve quality while cutting costs, federal officials announced Monday that they want programs such as accountable care organizations and bundled care to account for 50 percent of traditional Medicare spending by the end of 2018.

Bets On Health Care Paying Off For Investors

June 3, 2015 Morning Briefing

Despite high prices, shares of health care companies continue to soar. Elsewhere, an investor wins an arbitration award against UBS, the feds crack down on Medicare Advantage fraud and health insurer Anthem is offering workers free college tuition to entice new employees.

Pilot Programs To Improve Care For Elderly Or Disabled Poor Patients Stumble

December 24, 2015 Morning Briefing

The experiments — mandated by the health law — are designed to reduce spending and boost the quality of care for people who qualify for both Medicare and Medicaid, but they have failed to attract much enrollment. Also in the news, a study finds gender differences among patients taking advantage of new Medicare rules for screening colonoscopies.

Grassley Urges Tighter Scrutiny Of Medicare Advantage Plans; House ‘Cures’ Bill Mark Up Delayed

May 21, 2015 Morning Briefing

In other Capitol Hill happenings, supporters of the 340B Drug Discount program urge lawmakers not to make changes in it as part of the “Cures” bill that would overhaul the FDA’s drug approval process. Meanwhile, House Speaker John Boehner, R-Ohio, gives a bleak VA progress report.

Growth In U.S. Health Spending In 2013 Is Lowest Since 1960

By Mary Agnes Carey December 3, 2014 KFF Health News Original

The report credits slower growth in spending for private health insurance, Medicare, hospitals, physicians and clinical services.

Seniors’ Wait For A Medicare Appeal Is Cut In Half

By Susan Jaffe December 23, 2014 KFF Health News Original

Federal officials handle most of the requests in 2014 from beneficiaries seeking a hearing before a judge and cut into the heavy backlog. But cases from hospitals, doctors and other providers are still on hold.

Administration Announces Increased Payments To Medicare Advantage Plans

April 7, 2015 Morning Briefing

The final announcement about rates reverses a slight decrease proposed in February. Also in Medicare news, The Hill looks at a lobbying effort seeking to derail the House bill to revamp payments to doctors and the departing head of MedPAC looks back at his tenure.

Medicare Advantage Enrollment Continues To Climb Despite Insurers’ Complaints

April 13, 2015 Morning Briefing

Consumers flock to the programs because of the broad benefit packages and affordable premiums, reports Modern Healthcare. Meanwhile, Pennsylvania officials threaten action to protect Medicare Advantage enrollees caught in a spat between UPMC and Highmark and a draft rule would give Medicare providers greater flexibility to show they are using digital records.

Pressure From Industry, Lawmakers Protects Medicare Advantage Rates

April 9, 2015 Morning Briefing

The Obama administration has repeatedly backed away from proposed rate cuts as a result of the outcry from insurers and lawmakers of both parties. Nonetheless, DaVita HealthCare Partners warns investors that new risk calculation scores will hurt the company’s bottom line.

Medicare Open Enrollment Is Fast Approaching — Here’s What We Know So Far

By Michelle Andrews September 30, 2014 KFF Health News Original

Kaiser Health News consumer columnist gives readers some basic information to help them weigh their Medicare options.

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