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A Trump administration Medicare rule will push some hospital patients into a Catch-22: The government says several hundred procedures no longer need to be done in a hospital, but it did not approve them to be performed elsewhere. So patients will still need to use a hospital while not officially admitted — and may be charged more out-of-pocket for the care.
Progressive and conservative Democratic lawmakers, as well as President Joe Biden, are in favor of authorizing federal officials to negotiate with drugmakers over what Medicare pays for at least some of the most expensive brand-name drugs and to base those prices on the drugs’ clinical benefits. Such a measure could put Republicans in the uncomfortable position of opposing an idea that most voters from both parties generally support.
Health organizations have begun sending doctors and nurses to apartment buildings and private homes to vaccinate homebound seniors, but the efforts are slow and spotty.
Renowned medical centers are among the quarter of general hospitals that will lose 1% of Medicare payments for one year because their patients have high rates of bedsores, sepsis and other preventable complications.
Marilyn Bartlett, credited with saving Montana’s state employee health plan millions of dollars, is a busy consultant now, as states, counties and big businesses try to use her playbook to bring down hospital costs.
Lawmakers answered pleas from strained health facilities in rural areas, agreed to cover the cost of training more new doctors, sought to strengthen efforts to equalize mental health coverage with that of physical medicine and instructed the federal government to collect data that could be used to rein in high medical bills.
Those walking away free were facing years in prison for crimes of “unbounded greed.”
In late December, then-President Donald Trump signed a law that eliminates — only for people with Lou Gehrig’s disease — the required five-month waiting period before benefits begin under the Social Security Disability Insurance program. Gaining SSDI also gives these patients immediate Medicare health coverage.
A Kansas woman thought she’d find help at her local emergency room. What she found instead was a packed hospital and an ambulance ride to someplace else.
As the pandemic hits Latino communities especially hard, Illinois is expanding public health insurance to all low-income noncitizen seniors. Advocates hope other states follow its lead.
Most private insurance will be required to cover drugs, like Truvada, that offer protection against HIV infection, without making plan members share the cost.
While many private insurers cap what members pay in health costs, Medicare does not. Democrats and Republicans in Congress have proposed annual limits ranging from $2,000 to $3,100. But there’s disagreement about how to pay for that cost cap.
The coronavirus pandemic colored just about everything in 2020. But there was other health policy news that you either never heard or might have forgotten about: the Affordable Care Act going before the Supreme Court with its survival on the line; ditto for Medicaid work requirements. And a surprise ending to the “surprise bill” saga. Joanne Kenen of Politico, Anna Edney of Bloomberg News and Sarah Karlin-Smith of Pink Sheet join KHN’s Julie Rovner to discuss these issues and more.
It’s a complex program with many options — as well as confusing rules and nuances. Here’s how to get reliable guidance.
The tax was touted as a way to generate funding for treatment programs across the state. But to avoid paying, scores of manufacturers and wholesalers stopped selling opioids in New York.
Hospitals, a potent political force, fear lowering the eligibility age will cost them billions of dollars in revenue because federal reimbursements are lower than private insurers’.
The U.S. Supreme Court will hear arguments Tuesday in a case that could overturn the Affordable Care Act. California Attorney General Xavier Becerra, who is defending the law with the backing of more than 20 other states, told California Healthline that he predicts the justices will uphold it.
Democrats had hoped not only to defeat President Donald Trump but also to capture the Senate so they could make major policy changes, such as bolstering the Affordable Care Act and reducing the number of uninsured.
For Californians who are buying their own insurance, enrollment in 2021 health plans runs through Jan. 31.
The penalties are the ninth round of a program created as part of the Affordable Care Act’s broader effort to improve quality and lower costs. The average reduction in federal payments is 0.69%, with 613 hospitals receiving a penalty of 1% or more.
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