Medicare Failed To Recover Up To $125 Million In Overpayments, Records Show
Medicare overpaid five insurance plans by $128 million yet only recovered $3 million, audits show.
CMS
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Bundled Payments Work, Study Finds, But HHS Nominee No Fan
A study found that Medicare’s bundled payments model for joint replacement could save the government billions of dollars without harming patient care.
By Rachel Bluth -
New Special Enrollment Rules Will Shift Paperwork Burden To Consumers
Federal officials provide details about a pilot project starting in June that will delay some consumers' mid-year marketplace enrollment until they produce documentation proving eligibility.
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Health Law’s Test Kitchen For Payment Reforms Could Offer Tool For GOP Ideas
The Centers for Medicare & Medicaid Innovation was charged by the health law with exploring payment reforms that could cut health care costs and possibly improve quality. But its future is hinged to whether GOP lawmakers see value in its work.
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Trump’s Pick To Run Medicare And Medicaid Has Red State Policy Chops
Seema Verma is a consultant who was Vice President-elect Mike Pence's health policy advisor when he was governor of Indiana, playing a key role in Medicaid expansion in that state.
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In Depressed Rural Kentucky, Worries Grow Over Medicaid
Low-income residents in poverty-stricken Clay County worry what will happen to their health care if Gov. Matt Bevin’s ambitions to overhaul the state’s Medicaid program go forward.
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Medicare Bars New ‘Seamless Conversion’ Efforts For Some Seniors
Some insurers have been allowed to move customers on the health law's marketplaces into their Medicare Advantage plans when they become eligible for Medicare, but seniors complain they didn’t always know it was happening.
By Susan Jaffe -
How To Enroll In Medicare And Avoid Costly Mistakes
Enrolling in Medicare is confusing and mind-boggling if you don’t act at the right time and avoid costly mistakes.
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Feds Find Doctor Listings Often Wrong In Medicare Advantage Directories
The federal government's first in-depth review reveals errors such as wrong addresses and incorrect phone numbers riddle many directories used by Medicare Advantage beneficiaries.
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Officials Warn Some Older Marketplace Customers To Switch To Medicare
The government is sending emails and letters to some seniors to warn them that if they are eligible for Medicare and stay on the health law's exchange, they will have to repay any subsidies they receive and if they miss their Medicare enrollment opportunity, they will face a life-long penalty.
By Susan Jaffe -
‘Simple Choice Plans’ To Debut In 2017 Marketplace Enrollment
The standardized policy options would provide a way for consumers to make apples-to-apples comparisons.
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Doctors Raise Concerns For Small Practices In Medicare’s New Payment System
The government is laying out plans to use payment incentives to promote higher quality care, but physicians say the new system may be hard on solo practices and small groups.
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As The For-Profit World Moves Into An Elder Care Program, Some Worry
PACE, a little-known Medicare program that helps keep older people in their own homes, is allowing for-profit companies in. Tech and venture capital have expressed interest.
By Sarah Varney -
CMS Identifies Hospitals Paid Nearly $1.5B In 2015 Medicare Billing Settlement
A year after settling billing disputes with 2,022 hospitals for 68 cents on the dollar, the government has revealed who got paid and how much.
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Administration Paints Rosy Future For Obamacare Marketplaces
Report portrays Affordable Care Act’s individual market as improving with rising enrollments of healthier, lower-risk consumers, a performance that clashes with recent complaints from some large insurers.
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Teaching In-Home Caregivers Seems To Pay Off
Intensive training for such aides helps reduce repeated ER visits and hospitalizations of elderly disabled people, a pilot project suggests.
By Anna Gorman -
Many Well-Known Hospitals Fail To Score 5 Stars In Medicare’s New Ratings
Of the 102 hospitals that received a five-star rating, few are among the elite generally praised for great care.
By Jordan Rau -
Kentucky And Feds Near Possible Collision On Altering Medicaid Expansion
By Aug. 1, Republican Gov. Matt Bevin is expected to ask the Obama administration to approve significant changes on many Medicaid enrollees, including monthly premiums and a work requirement.
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Medicare Prepares To Go Forward With New Hospital Quality Ratings
The government will soon give hospitals one to five stars to sum up their quality. Some safety hospitals and teaching hospitals won’t fare as well as other facilities.
By Jordan Rau -
Doctors Wrestle With Mixed Messages When Deciding Whether To Prescribe Painkillers
Though the CDC’s new prescribing guidelines follow a theme of less is more, another federal agency’s patient satisfaction surveys include questions about pain management that some say encourage doctors to prescribe the highly addictive medicines.