Justice Department Targets Data Mining in Medicare Advantage Fraud Case
The feds’ civil suit links exaggerated patient bills to “tens of millions” in overcharges.
Medicare
421-440 of 1,610 results
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Apple, Bose and Others Pump Up the Volume on Hearing Aid Options, Filling Void Left by FDA
A 2017 law designed to help lower the cost of hearing aids mandated that federal officials set rules for a new class of devices consumers could buy without needing to see an audiologist. But those regulations are still on hold.
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Readers and Tweeters Ponder Vaccines and Points of Fairness
Kaiser Health News gives readers a chance to comment on a recent batch of stories.
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Biden’s No-Jab-No-Job Order Creates Quandary for Nursing Homes
Nursing home operators acknowledge that large numbers of staff members are not getting the shots but fear a federal vaccination mandate could drive away workers in a tight labor market.
By Jordan Rau and Andy Miller -
KHN’s ‘What the Health?’: Booster Time
As the delta variant continues to spread around the U.S., the Biden administration is taking steps to authorize covid vaccine boosters, require nursing home workers to be vaccinated and protect school officials who want to require masks despite state laws banning those mandates. Meanwhile, the U.S. House is returning from its summer break early to start work on its giant budget bill, which includes a long list of health policy changes. Alice Miranda Ollstein of Politico, Margot Sanger-Katz of The New York Times and Kimberly Leonard of Business Insider join KHN’s Julie Rovner to discuss these issues and more.
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KHN’s ‘What the Health?’: The Senate Acts
The U.S. Senate worked well into its scheduled August recess to pass a bipartisan infrastructure bill and a budget blueprint that outlines a much larger bill — covering key health priorities — to be written this fall. Meanwhile, the latest surge of covid is making both employers and schools rethink their opening plans. Joanne Kenen of Politico, Mary Ellen McIntire of CQ Roll Call and Yasmeen Abutaleb of The Washington Post join KHN’s Julie Rovner to discuss these issues and more. Also, for “extra credit,” the panelists suggest their favorite health policy stories of the week they think you should read, too.
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Why Doesn’t Medicare Cover Services So Many Seniors Need?
When the program began half a century ago, backers believed the benefits would expand over time, but politics and concerns about money have stymied most efforts. Now congressional Democrats are looking to add vision, dental and hearing care.
By Julie Rovner -
2+2=? Senate Uses Murky Math as It Shelves Drug Pricing Rule to Fund Infrastructure
The Medicare rule, designed by the Trump administration to take money away from drug industry brokers and provide refunds to patients, has not been implemented. But budget analysts say if it were, it would cost the government money. So senators are pushing the rule aside and claiming to save billions of dollars, which they want to use instead on new projects.
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Pfizer Court Fight Could Legalize Medicare Copays and Unleash ‘Gold Rush’ in Sales
Pharmaceutical companies routinely cover the cost of patient copays for expensive drugs under private insurance. A federal judge could make the practice legal for millions on Medicare as well.
By Jay Hancock -
Though Millions Are at Risk for Diabetes, Medicare Struggles to Expand Prevention Program
Medicare has proposed revamping its payment rules to get more people into a diabetes prevention plan that helps them eat better, exercise more and maintain a healthier lifestyle. Out of an estimated 16 million Medicare beneficiaries whose excess weight and other risk factors make them eligible, only 3,600 have participated since 2018.
By Harris Meyer -
Sen. Wyden: $3.5T Budget May Have to Trim but It Can Set a Path to ‘Ambitious Goals’
Sen. Ron Wyden (D-Ore.), who is helping to negotiate the health care spending framework for the Democrats' budget plan, said lawmakers may have to settle for very basic versions of programs deployed in the package. But the key, he added, is to get the "architecture of these changes, bold changes," started and show people what is possible.
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California Makes It Easier for Low-Income Residents to Get and Keep Free Health Coverage
State lawmakers aim to expand Medicaid enrollment by dedicating billions of dollars in coming years to simplifying paperwork, extending pregnancy coverage and opening the program to thousands of new enrollees, including older unauthorized immigrants and people who need nursing home care.
By Rachel Bluth -
KHN’s ‘What the Health?’: Here Comes Reconciliation
Democrats in Congress reached a tentative agreement to press ahead on a partisan bill that would dramatically expand health benefits for people on Medicare, those who buy their own insurance and individuals who have been shut out of coverage in states that didn’t expand Medicaid. Meanwhile, controversy continues to rage over whether vaccinated Americans will need a booster to protect against covid-19 variants, and who will pay for a new drug to treat Alzheimer’s disease. Rachel Cohrs of Stat and Sarah Karlin-Smith of the Pink Sheet join KHN’s Julie Rovner to discuss these issues and more. Also, Rovner interviews KHN’s Rae Ellen Bichell, who reported and wrote the latest KHN-NPR “Bill of the Month” episode about a mother and daughter who fought an enormous emergency room bill.
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Senate Democrats’ Plan Boosts Spending on Medicare, ACA Subsidies, Long-Term Care
The plan from high-wire negotiations would affect five key areas of health, but there will be further tense negotiations among Democratic lawmakers about specifics of the $3.5 trillion in funding. And all Senate Democrats will need to be behind the plan, because Republicans oppose it.
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As Congress Wrestles With Plans to Expand Medicare, Becerra Says Any One Will Do
In an interview for KHN’s “What the Health?” podcast, HHS Secretary Xavier Becerra says the administration is eager for Congress to make changes to Medicare that will provide more benefits and make more older adults eligible for the program. He also said a priority will be making permanent the enhanced premium subsidies for Affordable Care Act marketplace plans.
By Julie Rovner -
KHN’s ‘What the Health?’: Becerra Urges Congress to Expand Medicare, Address Rx Prices
Health and Human Services Secretary Xavier Becerra is the special guest for this bonus episode of KHN’s “What the Health?” podcast. He and host Julie Rovner discuss a breadth of topics the secretary oversees, including covid-19, prescription drug prices, Medicare, Medicaid and the Affordable Care Act.
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Drugmakers’ Spending on Stock, Dividends and Executive Pay Exceeds Research, Democrats Say
The pharmaceutical industry argues that large profits are needed to fund extensive research and innovation. But Democrats on the House Oversight and Reform Committee, seeking to bolster their effort to let Medicare negotiate drug prices, say major drug companies plow more of their billions in earnings back into propping up their stock and enriching executives and shareholders.
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Paying Billions for Controversial Alzheimer’s Drug? How About Funding This Instead?
Aduhelm, approved by the Food and Drug Administration last month despite questions about its efficacy, could be prescribed to at least 1 million patients a year, for a price tag of about $56 billion. Experts suggest there might be better ways to spend that money.
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Hospital Prices Must Now Be Transparent. For Many Consumers, They’re Still Anyone’s Guess.
A Trump administration rule mandating that hospitals disclose true prices on their websites took effect this year. But compliance is spotty and even when the data is public, it’s hard to find and understand.
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KHN’s ‘What the Health?’: Un-Trumping the ACA
The Biden administration is moving to undo many of the changes the Trump administration made to the enrollment process for the Affordable Care Act to encourage more people to sign up for health insurance. Meanwhile, Congress is opening investigations into the controversial approval by the Food and Drug Administration of an expensive drug that might (or might not) slow the progression of Alzheimer’s disease. Joanne Kenen of Politico, Kimberly Leonard of Insider and Sarah Karlin-Smith of the Pink Sheet join KHN’s Julie Rovner to discuss these issues and more. Also, Rovner interviews Marshall Allen of ProPublica about his new book, “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win.”