Medicare Advantage Archives - Page 2 of 7 - ��ýҕ�l Health News

What the Health? From ��ýҕ�l Health News

Can Congress Reconcile Trump’s Wishes With Medicaid’s Needs?

Episode 394

April 24, 2025

When Congress returns next week, it will be writing a budget reconciliation bill that’s expected to cut taxes but also make deep cuts to Medicaid. But at least some Republicans are concerned about cutting a program that aids so many of their constituents. Sarah Karlin-Smith of the Pink Sheet, Tami Luhby of CNN, and Alice Miranda Ollstein of Politico join ��ýҕ�l Health News’ Julie Rovner to discuss this story and more. Also, Rovner interviews ��ýҕ�l Health News’ Rae Ellen Bichell about her story on how care for transgender minors is changing in Colorado.

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The Week in Brief

Some Rural Hospitals Ditch Medicare Advantage

Get our weekly newsletter, The Week in Brief, featuring a roundup of our original coverage, Fridays at 2 p.m. ET.

By Arielle Zionts

April 11, 2025

A man in business attire, with short-cut greying hair, stands in front of a hospital building. With his hands on his hips, he smiles. Behind him, building signage reads: "Brookings Health System"

Rural Hospitals Question Whether They Can Afford Medicare Advantage Contracts

Some rural hospitals have canceled — or are considering ending — contracts with insurance companies that offer Medicare Advantage plans, saying the private policies jeopardize their finances and impede patient care.

By Arielle Zionts

April 8, 2025

UnitedHealth Wins Ruling Over $2B in Alleged Medicare Advantage Overpayments

A special master found the Justice Department failed to prove wrongdoing by the giant health insurer.

By Fred Schulte

March 4, 2025

A photo of a gavel resting on a stack of money.

In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M

A whistleblower suit alleged a health insurer bilked Medicare by exaggerating how sick patients were.

By Fred Schulte

Dec. 20, 2024

Health Brief

Federal Watchdog Urges Crackdown on Medicare Advantage Home Visits

By Fred Schulte

Nov. 22, 2024

A photo of Mehmet Oz speaking at a podium.

TV’s Dr. Oz Invested in Businesses Regulated by Agency Trump Wants Him To Lead

Celebrity doctor Mehmet Oz recently held broad investments in health care, tech, and food companies. Were he confirmed to run the Centers for Medicare & Medicaid Services, his job would involve interacting with giants of the industry that have contributed to his wealth.

By Darius Tahir

Nov. 21, 2024

What the Health? From ��ýҕ�l Health News

Trump’s Nontraditional Health Picks

Episode 373

Nov. 21, 2024

Not only has President-elect Donald Trump chosen prominent vaccine skeptic Robert F. Kennedy Jr. to lead the Department of Health and Human Services, Trump also has said he will nominate controversial TV host Mehmet Oz to run the Centers for Medicare & Medicaid Services, which oversees coverage for nearly half of Americans. Meanwhile, the lame-duck Congress is back in Washington with just a few weeks to figure out how to wrap up work for the year. Rachel Cohrs Zhang of Stat, Sandhya Raman of CQ Roll Call, and Riley Ray Griffin of Bloomberg News join ��ýҕ�l Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews Sarah Varney, who has been covering a trial in Idaho challenging the lack of medical exceptions in that state’s abortion ban.

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A photo of a gavel resting on its block in silhouette.

��ýҕ�l Health News Sues To Force Disclosure of Medicare Advantage Audit Records

Freedom of Information Act case targets HHS inspector general’s reviews of billions of dollars in health plan overpayments.

By Fred Schulte

Nov. 12, 2024

A photo of the sign in front of the Department of Health and Human Services' headquarters in Washington.

Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits

Medicare officials defend the use of home visits that often spot medical conditions that are never treated.

By Fred Schulte

Nov. 8, 2024

A photo of a person putting their ballot into a drop off box.

Election Outcome Could Bring Big Changes to Medicare

Democrats and conservatives are divided over whether the federal health program for people over 65 should be run almost entirely by the private sector. If Trump retakes the White House, the shift to Medicare Advantage may accelerate.

By Stephanie Armour

Nov. 4, 2024

��ýҕ�l Health News & PolitiFact HealthCheck

Vance Wrongly Blames Rural Hospital Closures on Immigrants in the Country Illegally

Experts disputed the claim by Republican vice presidential candidate JD Vance, noting that a range of other issues — from low reimbursement rates to declining patient use — combine to cause these facilities to shutter.

By Sam Whitehead

Oct. 29, 2024

Uber and Lyft signage on a vehicle in San Francisco, California,

Patients Are Relying on Lyft, Uber To Travel Far Distances to Medical Care

Uber and Lyft have become a critical part of the nation’s infrastructure for transporting ailing people from their homes — even in rural areas — to medical care sites in major cities such as Atlanta.

By Michael Scaturro

Oct. 17, 2024

A digital illustration of an outstretched hand holding a gold coin with a dollar sign on it. The sleeve around the person's wrist had white stars on a blue background and red and white stripes.

The Medicare Advantage Influence Machine

New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges.

By Fred Schulte and Holly K. Hacker

Sept. 30, 2024

Feds Killed Plan To Curb Medicare Advantage Overbilling After Industry Opposition

A private 2014 decision by the Centers for Medicare & Medicaid Services faces new scrutiny in a multibillion-dollar Justice Department fraud case against UnitedHealth Group.

By Fred Schulte

Aug. 27, 2024

A photo of medical professional treating a wound on a homeless patient.

A California Medical Group Treats Only Homeless Patients — And Makes Money Doing It

Healthcare in Action, a California medical group that exclusively serves homeless people, has tapped into growing demand and funding for street medicine services. Three years in, the innovative nonprofit is raking in revenue and serving thousands of people who otherwise might flock to the hospital for high-cost care.

By Angela Hart

July 19, 2024

Vertical images of three men, side by side. the first poses for the camera wearing a shirt and tie; second wearing a blue polo and smiling in front of shelves of prescriptions; third wearing a white coat and glasses, smiling in front of shelves of prescriptions.

Biden Plan To Save Medicare Patients Money on Drugs Risks Empty Shelves, Pharmacists Say

President Joe Biden is campaigning for reelection on his efforts to cut costs for Medicare patients at the pharmacy counter. But independent pharmacists say one strategy makes it unaffordable for them to keep some brand-name medicines in stock.

By Susan Jaffe

June 11, 2024

A senior man holds a letter from a Medicare provider. He is seated a table wearing glasses and a shirt and vest

Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage

Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. There’s a way out.

By Susan Jaffe

March 29, 2024