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Lawsuits: Medicare Advantage Plans Boost Payments By Claiming Sicker Patients

November 24, 2014 Morning Briefing

Also, retirees of big companies are being moved off of health plans, and advocates help African Americans understand their elevated risk of Alzheimer’s.

Medicare Advantage Plans Marked By Shortcomings

October 13, 2014 Morning Briefing

The New York Times reports that these problem areas include rejection of claims for medical services and limits on prescription drug coverage. News outlets also report on ACOs grades and Medicare Advantage rate shifts.

Medicare Testing Payment Options That Could End Observation Care Penalties

By Susan Jaffe July 22, 2014 KFF Health News Original

The pilot projects underway at hospitals eliminate the requirement that seniors must be admitted for three days before they qualify for nursing home coverage.

Decoding The High-Stakes Debate Over Medicare Advantage Cuts

By Jay Hancock April 7, 2014 KFF Health News Original

In high-visibility ad campaigns, insurers maintain that reduced payment rates, which are expected to be announced Monday, will do real harm. What should beneficiaries expect?

Physicians Contemplate Future Business Decisions Under ‘Doc Fix’ Cloud

October 28, 2014 Morning Briefing

In other Medicare news, an advocacy group analysis finds that seniors in six Michigan counties will pay more than others in the United States for their Medicare Advantage Plans. Also, the latest news on a Medicare class action suit.

Washington And Other States See New Insurers On Exchanges

By Pauline Bartolone, Capital Public Radio June 30, 2014 KFF Health News Original

This story is part of a partnership that includes Capital Public Radio, NPR and Kaiser Health News. It can be republished for free. (details) SEATTLE — Washington State’s health insurance exchange is looking to be an attractive marketplace for new health insurance carriers, according to an early analysis of insurer premium rate filings by McKinsey […]

Pain Doctors Profit From Drug Tests On Seniors

November 11, 2014 Morning Briefing

The Wall Street Journal reports that some Medicare doctors are making more from testing their patients for drug abuse than for treating them for pain. Another story looks at the need for better information to help seniors compare traditional Medicare and Medicare Advantage plans to figure out which is best for them.

Too Little, Too Late For Many New Yorkers Seeking Hospice

By Fred Mogul, WNYC December 17, 2014 KFF Health News Original

Evidence shows hospice care can extend life and save money, but only if patients and doctors dare ask for the help. One New Yorker said hospice gave her back a normal life — at peace, pain subdued.

Medicaid’s Western Push Hits Montana

By Eric Whitney, Montana Public Radio January 6, 2015 KFF Health News Original

After sitting out the first full year of Obamacare’s Medicaid expansion, lawmakers in Montana have moved on to arguing — not about whether — but about how much federal cash to pull down.

Obama Administration Retreats On Private Medicare Rate Cuts

By Jay Hancock April 8, 2014 KFF Health News Original

But insurers still contest the claim that rates will rise slightly after arriving at their own calculations of the originally proposed cuts.

FTC Cracks Down On Companies Selling Phony Health Insurance

October 15, 2014 Morning Briefing

The firms sold consumers a discount card but it offered no health insurance benefits. Also in the news, a government researcher says federal officials need to monitor billing errors and overpayments to Medicare Advantage plans.

Some Dementia Can Be Treated, But My Mother Waited 10 Years For A Diagnosis

By Roni Caryn Rabin March 3, 2015 KFF Health News Original

For many physicians, normal pressure hydrocephalus, or NPH, doesn’t come to mind when they see people with cognitive and gait problems, although it is one of the few treatable causes of dementia.

Methodology: How Hospital-Acquired Conditions Are Calculated

By Jordan Rau June 22, 2014 KFF Health News Original

Before assessing penalties, Medicare assesses rates of infection among patients with catheters in major veins and in the bladder and eight other patient injuries, such as blood clots, bed sores and accidental falls.

Study Questions Need For Long-Term Care Insurance For Most People

November 13, 2014 Morning Briefing

The analysis by Boston College’s Center for Retirement Research found the insurance makes financial sense only for the richest 20 to 30 percent of unmarried people. Other reports look at an executive shuffle at UnitedHealth Group and the assertion by WellCare Health Plans that the government’s star rating system for Medicare Advantage plans is biased against those serving low-income people.

Draft Rules Would Help Protect Seniors When Medicare Advantage Plans Drop Doctors

By Susan Jaffe March 24, 2014 KFF Health News Original

The proposals by federal officials come in response to UnitedHealthcare’s efforts to cancel contracts with thousands of doctors in 10 states just weeks before seniors had to enroll in plans.

Impact Of Medicare Advantage Cuts On Seniors Sharply Disputed

By Phil Galewitz February 23, 2014 KFF Health News Original

Experts say that costs may rise for some enrollees, but rates have been largely stable for most.

Letters To The Editor: The Health Insurance Affordability Gap; What’s Ahead For The Health Law; Doctor Burnout; Medicare Advantage Payment Rates

April 10, 2014 KFF Health News Original

Letters to the Editor is a periodic KHN feature.

Lawmakers Weigh Changes To Medicare

March 13, 2014 KFF Health News Original

The House this week held a hearing on payment shifts in Medicare Advantage plans and has scheduled a vote Friday on a proposal to revamp the system for paying doctors. KHN’s Mary Agnes Carey and Politico Pro’s Jennifer Haberkorn discuss the issues.

Bipartisan Group Of Senators Concerned About Medicare Advantage Cuts

By Mary Agnes Carey February 18, 2014 KFF Health News Original

Some Democrats have now joined their Republican counterparts in asking the Obama administration to moderate scheduled Medicare Advantage payment cuts for 2015. In a letter to Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner, a bipartisan coalition of 40 senators urged the administration “to maintain payment levels that will allow [Medicare Advantage] beneficiaries to […]

Obama Administration Proposes 1.9% Cut In Medicare Advantage Payments

By Mary Agnes Carey February 24, 2014 KFF Health News Original

Insurers claim the cuts are deeper and are campaigning to stop them, saying they will hurt seniors.

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