Dodging the Medicare Enrollment Deadline Can Be Costly
As open enrollment ends, many people are tuning out. They could wind up with a surprise next year: higher costs and less access to health care providers.
Medicare Advantage
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Uncle Sam Wants You … to Help Stop Insurers’ Bogus Medicare Advantage Sales Tactics
The Biden administration wants to crack down on deceptive or misleading Medicare Advantage and drug plan sales tactics. It’s counting on beneficiaries to help catch offenders.
By Susan Jaffe -
Medicare Advantage Increasingly Popular With Seniors — But Not Hospitals and Doctors
Some hospitals and physician groups are rejecting Medicare Advantage plans over payment rates and coverage restrictions, causing turmoil for patients.
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Medicare Enrollees Can Switch Coverage Now. Here’s What’s New and What to Consider.
Fall is the time when enrollees in the federal program for older people and people with certain disabilities can make changes to their health and drug plans. The decision can be complicated, but here are some key points to keep in mind.
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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 -
New Medicare Advantage Plans Tailor Offerings to Asian Americans, Latinos, and LGBTQ+
As more seniors opt for Medicare Advantage, a few small insurers have begun offering plans that provide culturally targeted benefits for cohorts including Asian Americans, Latinos, and LGBTQ+ people. The approach, policy researchers say, has potential and perils.
The Policy, and Politics, of Medicare Advantage
Episode 290Medicare Advantage, the private plan alternative to traditional Medicare, is embroiled in a growing controversy over whether insurers are being overpaid and what it would mean to reduce those payments. Meanwhile, even as maternal mortality in the U.S. continues to rise, providers of care to pregnant women say they’re leaving states with abortion bans that prevent them from treating pregnancy complications. Margot Sanger-Katz of The New York Times, Jessie Hellmann of CQ Roll Call, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico join KHN’s chief Washington correspondent Julie Rovner to discuss these issues and more.
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Proposed Medicare Advantage Changes Cannot Accurately Be Called ‘Cuts,’ Experts Say
CMS advanced two proposed changes that could affect Medicare Advantage plans. One would allow the government to recover past overpayments. As a result, it could reduce those insurers’ profits, leading them to increase enrollees' out-of-pocket costs or reduce benefits. But it's inaccurate to characterize the changes as "cuts."
Au Revoir, Public Health Emergency
Episode 283The Biden administration this week announced it would let the covid-19 public health emergency lapse on May 11, even as the Republican-led House was voting to immediately eliminate the special authorities of the so-called PHE. Meanwhile, anti-abortion forces are pressuring legislators to both tighten abortion restrictions and pay for every birth in the nation. Margot Sanger-Katz of The New York Times, Rachel Roubein of The Washington Post, and Victoria Knight of Axios join KHN’s chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews Hannah Wesolowski of the National Alliance on Mental Illness about the rollout of the national 988 suicide prevention hotline.
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Government Lets Health Plans That Ripped Off Medicare Keep the Money
In a surprise decision, U.S. officials yield to insurance industry demands — at least for now.
By Fred Schulte -
Did Your Health Plan Rip Off Medicare?
KHN has released never-before-seen details of federal audits as the government weighs action against dozens of Medicare Advantage plans.
By Fred Schulte -
How Medicare Advantage Plans Dodged Auditors and Overcharged Taxpayers by Millions
Facing rare scrutiny from federal auditors, some Medicare Advantage health plans failed to produce any records to justify their payments, government records show. The audits revealed millions of dollars in overcharges to Medicare over three years.
By Fred Schulte and Holly K. Hacker -
Lawsuit by KHN Prompts Government to Release Medicare Advantage Audits
The lawsuit was filed three years ago to learn about vast overcharges by the popular health plans that are detailed in audits the government refused to release to the public.
By Fred Schulte -
KHN’s ‘What the Health?’: Finally Fixing the ‘Family Glitch’
The Biden administration has decided to try to fix the so-called “family glitch” in the Affordable Care Act without an act of Congress. The provision has prevented workers’ families from getting subsidized coverage if an employer offer is unaffordable. Meanwhile, Medicare’s open enrollment period begins Oct. 15, and private Medicare Advantage plans are poised to cover more than half of Medicare’s 65 million enrollees. Margot Sanger-Katz of The New York Times, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, and Rachel Cohrs of Stat join KHN’s Julie Rovner to discuss these topics and more. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read.
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KHN’s ‘What the Health?’: Biden Declares the Pandemic ‘Over’
President Joe Biden, in an interview with CBS’ “60 Minutes,” declared the covid-19 pandemic “over,” stoking confusion for members of his administration trying to persuade Congress to provide more funding to fight the virus and the public to get the latest boosters. Meanwhile, concerns about a return of medical inflation is helping boost insurance premiums even as private companies race to get their piece of the health pie. Anna Edney of Bloomberg News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, and Lauren Weber of KHN join KHN’s Julie Rovner to discuss these issues and more. Also, for extra credit, the panelists suggest their favorite health policy stories they think you should read, too.
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Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging
The Government Accountability Office and the Health and Human Services inspector general’s office say seniors enrolled in the program are suffering and taxpayers are getting bilked for billions of dollars a year.
By Fred Schulte -
KHN’s ‘What the Health?’: Leaked Abortion Opinion Rocks Washington’s World
The unprecedented early leak of a Supreme Court draft opinion that would overturn the landmark abortion-rights ruling Roe v. Wade has heated the national abortion debate to boiling. Meanwhile, the FDA, after years of consideration, moves to ban menthol flavors in cigarettes and cigars. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Shefali Luthra of the 19th, and Jessie Hellmann of CQ Roll Call join KHN’s Julie Rovner to discuss these issues and more. Plus, Rovner interviews KHN’s Paula Andalo, who wrote the latest KHN-NPR “Bill of the Month” episode about a family whose medical debt drove them to seek care south of the border.
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KHN’s ‘What the Health?’: News You Might Have Missed
Congress is in recess, so the slower-than-average news week gives us a chance to catch up on underreported topics, like Medicare’s coverage decision for the controversial Alzheimer’s disease drug Aduhelm and ominous new statistics on drug overdose deaths and sexually transmitted diseases. Margot Sanger-Katz of The New York Times, Joanne Kenen of Politico and the Johns Hopkins Bloomberg School of Public Health, and Alice Miranda Ollstein of Politico join KHN’s Julie Rovner to discuss these issues and more. Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read, too.
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Medicare Advantage Plans Send Pals to Seniors’ Homes for Companionship — And Profits
Many Medicare Advantage plans send caregivers to the homes of seniors periodically to help with housework and provide companionship. But the workers may also prod seniors into activities that boost the plans’ Medicare ratings and federal reimbursements.