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Trump Administration Bumps Payment Rates For Medicare Insurers By 5%

April 8, 2025 Morning Briefing

The boost is double the one proposed in January by the Biden administration. Meanwhile, a study shows how UnitedHealth Group used certain strategies to get more money from Medicare Advantage.

Morning Briefing for Monday, September 30, 2024

September 30, 2024 Morning Briefing

Medicare Advantage, drug use, bird flu, health impact of big storm, IVF coverage, maternal health, and more are in the news.

Morning Briefing for Wednesday, October 16, 2024

October 16, 2024 Morning Briefing

Medical debt, birth control, IV fluid shortage, abortion law, long covid, Medicare Advantage plans, pharmacies closing, and more

Insurers Bilked $50B From Medicare For Dubious Diagnoses, Review Finds

July 8, 2024 Morning Briefing

In its analysis of the Medicare Advantage program, The Wall Street Journal looked at details of “doctor visits, hospital stays, prescriptions and other care.” Separately, a Stat review has found that more than two dozen Medicare Advantage insurers now qualify for big taxpayer-funded bonuses.

Regional Nonprofit Insurers See Largest Dip In Operating Margins

September 26, 2025 Morning Briefing

Smaller insurers were also found more susceptible to Medicaid cuts, a report found. Meanwhile, 29 states see at least a 20% increase in insurance rates from the top insurers. Also in the news: Medicare drug prices, Medicare Advantage, and more.

Listen to the Latest ‘KFF Health News Minute’

January 2, 2024 KFF Health News Original

“Health Minute” brings original health care and health policy reporting from the KFF Health News newsroom to the airwaves each week.

Feds Move to Rein In Prior Authorization, a System That Harms and Frustrates Patients

By Lauren Sausser March 13, 2023 KFF Health News Original

The federal government wants to change the way health insurers use prior authorization — the requirement that patients get permission before undergoing treatment. Designed to prevent doctors from deploying expensive, ineffectual procedures, prior authorization has become a confusing maze that denies or delays care, burdens physicians with paperwork, and perpetuates racial disparities. New rules may not be enough to solve the problems.

New Weight Loss Drugs Carry High Price Tags and Lots of Questions for Seniors

By Judith Graham July 25, 2023 KFF Health News Original

Although nearly 40% of Americans 60 and older are obese, Medicare doesn’t cover weight loss medications. Meanwhile, studies haven’t thoroughly examined new drugs’ impact on older adults.

GOP Can’t Attain Budget Goal Without Cuts To Medicaid, Medicare, Or CHIP

March 6, 2025 Morning Briefing

The nonpartisan Congressional Budget Office released an analysis Wednesday. Other coverage from Capitol Hill and the White House is on high-deductible health plans, price transparency, Medicare Advantage lawsuits, and more.

Moody’s Dings Health Insurance Sector With ‘Negative’ Outlook

February 5, 2025 Morning Briefing

The ratings agency expects Medicare Advantage, Medicaid, and commercial insurers to continue to see high medical costs this year. More industry news is about Baystate Health, Tricare East, and others.

Medicare To Test Prior Authorizations In 6 States As Part Of A Pilot Program

September 2, 2025 Morning Briefing

The program will use AI to review cases, which some experts say could lead to inappropriate denials of care. Also in the news: more on prior authorization, Medicare Advantage, the impact of Medicaid cuts on maternity care, aging alone, and more.

Former Medicare Chief Warns About Medicare Advantage Pay Rates

October 18, 2024 Morning Briefing

Donald Berwick, who ran Medicare during the Obama administration, says Medicare Advantage plans run by private insurers need a lot more regulation. He suggests a two-pronged system fix that would take the overpayments out of MA and use that money to cover vision, dental, and hearing service in traditional Medicare, Stat says.

Doctors and Patients Try to Shame Insurers Online to Reverse Prior Authorization Denials

By Lauren Sausser August 23, 2023 KFF Health News Original

Prior authorization is a common tool used by health insurers for many tests, procedures, and prescriptions. Frustrated by the process, patients and doctors have turned to social media to publicly shame insurance companies and elevate their denials for further review.

OIG Reports Reveal 3 Health Insurers’ Medicare Advantage Overcharges

September 27, 2024 Morning Briefing

Humana, HealthAssurance Pennsylvania, and EmblemHealth are accused of overcharging taxpayers to the tune of $140 million by exaggerating the severity of Medicare Advantage members’ illnesses.

Megabill Scraps ‘Silver Loading,’ Potentially Disrupting ACA Plans

June 12, 2025 Morning Briefing

Although the measure would reduce Silver plan premiums, an estimated 300,000 people would lose health coverage, experts say. Meanwhile, Senate Republicans won’t be targeting Medicare Advantage changes after all.

Morning Briefing for Tuesday, August 27, 2024

August 27, 2024 Morning Briefing

Open enrollment, opioid settlement funds, Medicare Advantage overbilling, weight loss drugs, extreme heat, mosquito-borne diseases, and more

Morning Briefing for Friday, October 18, 2024

October 18, 2024 Morning Briefing

Storm fallout on health care, teen tobacco use, Medicare Advantage plans, flu shot, emergency abortion care, and more. Plus, your weekend reads.

What the Health? From KFF Health News: The ‘Unwinding’ of Medicaid

April 6, 2023 Podcast

As of April 1, states were allowed to begin reevaluating Medicaid eligibility for millions of Americans who qualified for the program during the covid-19 pandemic but may no longer meet the income or other requirements. As many as 15 million people could lose health coverage as a result. Meanwhile, the Medicare Hospital Insurance Trust Fund is projected to stay solvent until 2031, its trustees reported, taking some pressure off of lawmakers to finally fix that program’s underlying financial weaknesses. Alice Miranda Ollstein of Politico, Rachel Roubein of The Washington Post, and Amy Goldstein of The Washington Post join KHN’s Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Daniel Chang, who reported the latest KHN-NPR “Bill of the Month” feature about a child not yet old enough for kindergarten whose medical bill landed him in collections.

Insurers Collected Billions In Dubious Medicare Advantage Payments: Watchdog Report

October 25, 2024 Morning Briefing

A HHS watchdog reports that insurers like UnitedHealth, Humana were paid an estimated $7.5 billion last year from health risk assessments that diagnosed serious health conditions for which patients had no follow-up care. The Centers for Medicare and Medicaid Services declined to crack down on the practice though.

Medicare Advantage Plans’ Quality Ratings From CMS Fall Again

October 11, 2024 Morning Briefing

Only 40% of Medicare Advantage health prescription drug plans achieved a four-star rating or higher under the current criteria used by Centers for Medicare and Medicaid Services to grade quality. The federal health agency has sought to make it harder to win top scores — in 2022, 68% of plans were four stars or higher.

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