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New reductions in Medicare payments in 2023 will drive more doctors away from accepting Medicare patients, physicians say. They are again pushing back on efforts largely designed to control government spending.
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.
A months-long KHN examination of the system meant to bar fraudsters from Medicaid, Medicare, and other federal health programs found gaping holes and expansive gray areas through which banned individuals slip to repeatedly bilk taxpayer-funded programs.
Sen. Raphael Warnock鈥檚 re-election in Georgia will give Democrats a clear-cut Senate majority for the first time in nearly a decade. Meanwhile, the current Congress has only days left to tackle major unfinished business on the health agenda, including fending off scheduled pay cuts for doctors and other health providers in the Medicare program. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Anna Edney of Bloomberg News, and Sandhya Raman of CQ Roll Call join KHN鈥檚 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, too.
Some doctors and medical practices voluntarily give rebates on a bill if an injury occurs during a procedure, while others will not, an expert says. Here鈥檚 how patients can respond.
Taxpayers had to foot the bills for care that should have cost far less, according to records released after KHN filed a lawsuit under the Freedom of Information Act. The government may seek to recover up to $650 million as a result.
In August, Congress approved a $35 cap on what seniors will pay for insulin, but that change came too late to add to the online tool that helps Medicare beneficiaries compare dozens of drug and medical plans. Federal officials say beneficiaries who use insulin will have the opportunity to switch plans after open enrollment ends Dec. 7.
Federal officials said they are penalizing 2,273 hospitals, the fewest since the fiscal year that ended in September 2014. Driving the decline was a change in the formula to compensate for the chaos caused by the covid-19 pandemic.
Complaints about misleading health insurance marketing are soaring. State insurance commissioners are taking notice. They鈥檝e created a shared internal database to monitor questionable business practices, and, in the future, they hope to provide a public-facing resource for consumers. In the meantime, consumers should shop wisely as open enrollment season begins.
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here鈥檚 a collection of their appearances.
A North Carolina state treasurer鈥檚 report found hospitals give conflicting information about whether they profit from Medicare patients. Experts said the findings are significant because they suggest the federal government has failed to closely watch the billions of dollars in tax breaks that nonprofit hospitals have received.
Medicare can pay for some dental care if it is medically necessary to safely treat another covered medical condition, and federal officials have asked for suggestions on whether that list of conditions should be expanded.
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.
The Biden administration has decided to try to fix the so-called 鈥渇amily glitch鈥 in the Affordable Care Act without an act of Congress. The provision has prevented workers鈥 families from getting subsidized coverage if an employer offer is unaffordable. Meanwhile, Medicare鈥檚 open enrollment period begins Oct. 15, and private Medicare Advantage plans are poised to cover more than half of Medicare鈥檚 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鈥檚 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.
The human body mass index 鈥 a simple mathematical equation 鈥 is tied to a measure of obesity invented almost 200 years ago. On the downside, it can stand between patients and treatment for weight issues. It particularly mismeasures Black women and Asians.
A new 麻豆女优 poll shows Democrats and those living in states where abortion is illegal say the issue has made them more motivated to vote. It also shows that 70% of Republicans oppose total abortion bans.
Congress won鈥檛 be back in Washington until after Election Day, but lawmakers have left themselves a long list of items to finish up in November and December, including unfinished health care policies. Sandhya Raman of CQ Roll Call; Jessie Hellmann, also of CQ Roll Call; and Mary Agnes Carey of KHN join KHN鈥檚 Julie Rovner to discuss these topics and more. Also this week, Rovner interviews KHN鈥檚 Sam Whitehead, who reported and wrote the latest KHN-NPR 鈥淏ill of the Month鈥 episode about a family who tried to use urgent care to save money, but ended up with a big emergency room bill anyway.
Private Medicare Advantage health plans are increasingly ending coverage for skilled nursing or rehab services before medical providers think patients are healthy enough to go home, doctors and patient advocates say.
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Here鈥檚 a collection of their appearances.
Congress has once again decided not to decide how to fund the federal government in time for the start of the fiscal year, racing toward a midnight Sept. 30 deadline to pass a stopgap bill that would keep the lights on for two more months. However, it does appear the FDA鈥檚 program that gets drugmakers to help fund some of the agency鈥檚 review staff will be renewed in time to stop pink slips from being sent. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Victoria Knight of Axios join KHN鈥檚 Julie Rovner to discuss these topics and more. Also this week, Rovner interviews filmmaker Cynthia Lowen, whose new documentary, 鈥淏attleground,鈥 explores how anti-abortion forces played the long game to overturn Roe v. Wade.
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