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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.
Some hospitals and physician groups are rejecting Medicare Advantage plans over payment rates and coverage restrictions, causing turmoil for patients.
Congress narrowly avoided a federal government shutdown for the second time in six weeks, as Democrats came to the rescue of divided House Republicans over annual spending bills that were supposed to be finished by Oct. 1. But the brinksmanship is likely to repeat itself early in 2024, when the next temporary spending patches expire. Meanwhile, a pair of investigations unveiled this week demonstrate how difficult it still is for seniors to get needed long-term and rehabilitation care. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Joanne Kenen of Johns Hopkins University and Politico Magazine join KFF Health News’ Julie Rovner to discuss these issues and more.
Many proposals have been floated about how to address the nation’s primary care problem. They range from training slots to medical school debt forgiveness but often sidestep comprehensive payment reform.
The government has proposed that Medicare fully cover preexposure prophylaxis drugs that prevent HIV, a change that could help America catch up with nations in Europe and Africa that are on track to end new infections decades before the U.S. under its current approach.
Medicare is expanding access to mental health counselors and marriage and family therapists come Jan. 1. But the belief that seniors who suffer from mental health problems should just grin and bear it remains a troubling barrier to care.
More than half of seniors are enrolled in private Medicare Advantage plans instead of traditional Medicare. Rural enrollment has increased fourfold and many small-town hospitals say that threatens their viability.
Open enrollment for Medicare beneficiaries with private health plans began Oct. 15, to be followed Nov. 1 by open enrollment for Affordable Care Act plans. The selection for both is large — often too large to be navigated easily alone. And people who choose incorrectly can end up with unaffordable medical bills. Meanwhile, those on both sides of the abortion issue are looking to Ohio’s November ballot measure on abortion to see whether anti-abortion forces can break their losing streak in statewide ballot questions since the overturn of Roe v. Wade in 2022.
This month, the federal government started paying for treatments delivered outside hospitals and clinics, expanding funding for “street medicine” teams that treat homeless patients. California led the way on the change, which could help sick and vulnerable patients get healthy, sober, and, in some cases, into housing.
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.
A new rule sets specific treatment metrics for suspected sepsis cases in an effort to reduce deaths, but some experts say the measures could add to antibiotic overuse and need to be more flexible.
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.
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.
At least 30 states are reinstating coverage for children wrongly removed from the rolls under Medicaid redetermination, the federal government reported. It’s just the latest hiccup in the massive effort to review the eligibility of Medicaid beneficiaries now that the program’s pandemic-era expansion has expired. And federal oversight of the so-called unwinding would be further complicated by an impending government shutdown. Rachel Roubein of The Washington Post, Sandhya Raman of CQ Roll Call, and Sarah Karlin-Smith of Pink Sheet join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KFF Health News’ Samantha Liss, who reported and wrote the latest KFF Health News-NPR “Bill of the Month” feature, about a hospital bill that followed a deceased patient’s family for more than a year.
Medicare and Medicaid shouldn’t be affected, but confusion can be expected.
Congress appears to be careening toward a government shutdown, as a small band of House conservatives vow to block any funding for the fiscal year that begins Oct. 1 unless they win deeper cuts to health and other domestic programs. Meanwhile, former President Donald Trump continues to roil the GOP presidential primary field, this time with comments about abortion. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Tami Luhby of CNN join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and more. Also, for “extra credit,” the panelists suggest health policy stories they read this week they think you should read, too.
Before covid-19, hepatitis C held the distinction of claiming more American lives each year than any other infectious disease — that’s despite the marketing of several relatively affordable, highly effective treatments.
The percentage of working-age adults with health insurance went up and the uninsured rate dropped last year, the U.S. Census Bureau reported this week. There isn’t much suspense about which way the uninsured rate is now trending, as states continue efforts to strip ineligible beneficiaries from their Medicaid rolls. But is the focus on the uninsured obscuring the struggles of the underinsured? Margot Sanger-Katz of The New York Times, Sarah Karlin-Smith of the Pink Sheet, and Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico join KFF Health News’ Emmarie Huetteman to discuss these issues and more.
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