CMS
121-140 of 421 results
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Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage
Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. There’s a way out.
By Susan Jaffe -
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Readers Slam Hospital Monopolies and Blame the Feds for Understaffed Nursing Homes
KFF Health News gives readers a chance to comment on a recent batch of stories.
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Lost in the Mix of Medicaid ‘Unwinding’: Kentucky Cut Off Her Health Care Over a Clerical Error
The state canceled Beverly Likens’ coverage — days before surgery — without considering other ways she qualified for Medicaid, which experts say violated federal regulations.
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Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients
Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and then predicts what kind of care an individual will need and for how long. New federal rules will ensure human experts are part of the process.
By Susan Jaffe -
These Appalachia Hospitals Made Big Promises to Gain a Monopoly. They’re Failing to Deliver.
Ballad Health, the only hospital system across a large swath of Tennessee and Virginia, has fallen short of quality-of-care and charity care obligations — even as it’s sued thousands of patients for unpaid bills.
By Brett Kelman and Samantha Liss -
Biden Administration Proposes New Standards to Boost Nursing Home Staffing
The proposal would require major hiring at the most sparsely staffed homes. But the proposal is already badly received by the nursing home industry, which claims it can’t boost wages enough to attract workers.
By Jordan Rau -
Exclusive: CMS Study Sabotages Efforts to Bolster Nursing Home Staffing, Advocates Say
Research commissioned by the Centers for Medicare & Medicaid Services analyzed only staffing levels below what experts have previously called ideal. Patient advocates have been pushing for more staff to improve care.
By Jordan Rau -
After Backlash, Feds Cancel Plan That Risked Limiting Breast Reconstruction Options
The Centers for Medicare & Medicaid Services backed off from a plan that could have curtailed access to a type of reconstructive surgery known as DIEP flap. Breast cancer patient advocates are relieved.
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Look Up Your Hospital: Is It Being Penalized by Medicare?
Each year, Medicare punishes hospitals that have high rates of readmissions and high rates of infections and patient injuries. Check out which hospitals have been penalized.
By Jordan Rau -
The Real Costs of the New Alzheimer’s Drug, Most of Which Will Fall to Taxpayers
The annual cost of lecanemab treatment quadruples if the expense of brain scans to monitor for bleeds and other associated care is factored in. The full financial toll likely puts it beyond reach for low-income seniors at risk of Alzheimer’s, experts say.
By Arthur Allen Let’s Talk About the Weather
Episode 306It’s been the summer of broken weather records around the world — for heat, rain, and wildfire smoke — advertising the risks of climate change in a big way. But, apparently, it’s not enough to break the logjam in Washington over how to address the growing climate crisis. Meanwhile, in Texas, women who were unable to get care for pregnancy complications took their stories to court, and Congress gears up to — maybe — do something about prescription drug prices. Alice Miranda Ollstein of Politico, Shefali Luthra of The 19th, and Rachel Cohrs of Stat join Julie Rovner, KFF Health News’ chief Washington correspondent, to discuss these issues and more. Also this week, Rovner interviews Meena Seshamani, the top administrator for the federal Medicare program.
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How a Medical Recoding May Limit Cancer Patients’ Options for Breast Reconstruction
The federal government’s arcane process for medical coding is influencing which reconstructive surgery options are available, creating anxiety for breast cancer patients.
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Doctor Shortages Distress Rural America, Where Few Residency Programs Exist
Patients in rural northeastern Nevada soon will have fewer providers and resources, after a local hospital decided to close its medical residency program. Nationally, the number of rural residency slots has grown during the past few years but still makes up just 2% of programs and residents nationwide.
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The Big Squeeze: More Enrollees and Smaller Networks Plague Some ACA Plans
Despite record enrollment in health insurance plans under the Affordable Care Act, some consumers who bought coverage and agents who helped them do so have had a tough start to the new year: Many say it’s hard to find an in-network doctor or hospital.
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A Progress Check on Hospital Price Transparency
Hospitals are facing mixed reviews regarding their efforts to comply with a federal requirement that they post information about prices related to nearly every health care service they provide.