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Federal officials handle most of the requests in 2014 from beneficiaries seeking a hearing before a judge and cut into the heavy backlog. But cases from hospitals, doctors and other providers are still on hold.
In 2015, some seniors enrolled in Medicare Advantage plans will be allowed to switch if they lose their doctors.
Medicare is reducing payments to 721 hospitals with high rates of infections or other medical complications. About 1,400 hospitals, including all in Maryland, are excluded from the program and Medicare did not assess their rates of patient harm.
The 1 percent penalty, mandated by the health law, will hit one of every seven hospitals in the country and fall particularly hard on academic medical centers.
The data comes from the Centers for Disease Control and Prevention, which tracks six types of frequently occurring infections in hospitals as part of an effort to reduce them.
More insurers selling Affordable Care Act plans will charge consumers higher rates for medicines that treat multiple sclerosis, hepatitis C and other serious illnesses, Avalere studies say.
The government’s proposed rule addresses many concerns of accountable care organizations.
Advocates say many poor seniors who need dialysis and cancer treatments will have few transportation options.
Gary Cohen, a former deputy administrator for the Centers for Medicare & Medicaid Services, says the challenge for regulators and insurers is to create networks that not only save money but also deliver better patient outcomes.
Experts say low reimbursements and restrictions on providers have hampered the Medicare program.
The Commonwealth Fund finds cost barriers and limits on care for Medicare beneficiaries consistently places the U.S. low on the list of an 11-nation ranking of how older people fare in industrialized nations.
Nearly half of those eligible for a combined Medi-Cal and Medicare program are opting out.
Among the tools: penalties for admitting patients too soon after they were discharged and a focus on reducing hospital-acquired infections.
Though not a part of the health law’s open enrollment period, Medicare’s enrollment period runs during some of the same time period. Changes to Medicare advantage and the so-called Medicare prescription drug “doughnut hole” are taking center stage.
Beneficiaries who have a 30-year, pack-a-day smoking history would be eligible for this screening test.
Medicare announced Thursday it would continue covering devices that patients themselves can upgrade.
Federal officials are planning a wide range of audits into billing and government spending on managed health care in the new fiscal year, ranging from private Medicare Advantage groups that treat millions of elderly to health plans rapidly expanding under the Affordable Care Act.
On Wednesday, Medicare officials agreed to pay for Glenda Jimmo’s home health care, reversing an earlier denial that said she didn’t qualify for coverage because she was not improving.
The order follows a Kaiser Health News report detailing three fatal cases in which sources say recommended nursing home citations were downgraded.
Patient advocates say that, because of an official coverage reminder “the door is closing” for ALS patients who depend on Medicare to get speech-generation devices.
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