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For-profit hospitals provide most inpatient physical therapy but tend to have worse readmission rates to general hospitals. Medicare doesn’t tell consumers about troubling inspections.
A proposed work requirement would make Medicaid expansion enrollees prove they’re working or meet other criteria. Most already work, but millions are expected to lose coverage if the provision passes, many from red tape. A Missouri mother who cares for her disabled son would probably be subject to the rule.
Dozens of health insurance companies pledged on Monday to improve prior authorization, a process often used to deny care. The announcement comes months after the killing of UnitedHealthcare executive Brian Thompson, whose death in December sparked widespread criticism about insurance denials.
Republican proposals to tighten the use of special taxes to fund Medicaid programs could deprive states of billions of dollars for safety net health care. In California, any such limit would come on top of Medicaid cuts proposed by California Democrats in response to a $12 billion state deficit.
The vast majority of improper payments stem from documentation mistakes and do not fit the definition of waste, fraud, or abuse. They also typically stem from health care providers’ actions, not beneficiaries’ abuse.
This fall, the U.S. Government Accountability Office expects to release a report on how much it costs to run Georgia Pathways to Coverage — the country’s only active Medicaid work requirement program — as other states and Congress consider similar programs.
Breakups between health providers and Advantage plans are increasingly common. The Centers for Medicare & Medicaid Services has allowed whole groups of patients to leave their plans.
When Congress returns next week, it will be writing a budget reconciliation bill that’s expected to cut taxes but also make deep cuts to Medicaid. But at least some Republicans are concerned about cutting a program that aids so many of their constituents. Sarah Karlin-Smith of the Pink Sheet, Tami Luhby of CNN, and Alice Miranda Ollstein of Politico join KFF Health News’ Julie Rovner to discuss this story and more. Also, Rovner interviews KFF Health News’ Rae Ellen Bichell about her story on how care for transgender minors is changing in Colorado.
These fixers, officially known as caseworkers, unraveled complex and arcane health insurance rules to solve people’s coverage issues. They worked in a little-known federal department with which most consumers never interact — until they need help.
Health care price transparency is one of the few bipartisan issues in Washington, D.C. But much of the information that hospitals and health plans have made available to the public is not helpful to patients, and there’s no conclusive evidence yet that it’s lowering costs or increasing competition.
It’s the Trump administration vs. the federal courts, as the Department of Government Efficiency continues to try to cancel federal contracts and programs and fire workers. But in the haste to cut things, jobs and programs are being eliminated even if they align with the new administration’s goal to “Make America Healthy Again.” Jessie Hellmann of CQ Roll Call, Sarah Karlin-Smith of the Pink Sheet, and Rachel Roubein of The Washington Post join KFF Health News’ Julie Rovner to discuss these stories and more.
Rep. Ro Khanna of California warned of Trump administration “cuts” to Medicare telehealth access hitting March 31. But if Medicare recipients lose telemedicine benefits that day, it will be because Congress failed to act.
The Senate Finance Committee questioned Mehmet Oz, President Donald Trump’s nominee to lead the Centers for Medicare & Medicaid Services. KFF Health News reporters discussed the biggest takeaways from the hearing.
Unnecessarily high radiation doses in scans have been linked to cancers. Under new federal rules, doctors and imaging centers have to more closely track and report the doses of radiation that patients receive.
Some of the Trump administration’s dramatic funding and policy shifts are facing major pushback for the first time — not from Congress, but from the courts. Federal judges around the country are attempting to pump the brakes on efforts to freeze government spending, shut down the U.S. Agency for International Development, eliminate access to health-related webpages and datasets, and limit grant funding provided by the National Institutes of Health. Meanwhile, Congress is off to a slow start in trying to turn President Donald Trump’s agenda into legislation, although Medicaid is clearly high on the list for potential funding cuts. Shefali Luthra of The 19th, Jessie Hellmann of CQ Roll Call, and Maya Goldman of Axios News join KFF Health News’ Julie Rovner to discuss these topics and more. Also this week, Rovner interviews Mark McClellan, director of the Duke-Margolis Institute for Health Policy and a former health official during the George W. Bush administration, about the impact of cutting funding to research universities.
A whistleblower suit alleged a health insurer bilked Medicare by exaggerating how sick patients were.
The number of new and returning enrollees using healthcare.gov — the federal marketplace that serves 31 states — is well below last year’s as of early December. Also, a Biden administration push to give “Dreamers” access to Obamacare coverage and subsidies is facing court challenges.
Georgia’s ability to process applications for Medicaid and other public benefits has lagged since the launch of Republican Gov. Brian Kemp’s “Pathways” Medicaid work requirement, leaving Georgia with persistently slow Medicaid application processing times.
KFF Health News staffers and contributors made the rounds on national and local media this week to discuss their stories. Here’s a collection of their appearances.
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