Government Lets Health Plans That Ripped Off Medicare Keep the Money
In a surprise decision, U.S. officials yield to insurance industry demands ā at least for now.
Medicare
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Did Your Health Plan Rip Off Medicare?
KHN has released never-before-seen details of federal audits as the government weighs action against dozens of Medicare Advantage plans.
By Fred Schulte -
Abortion Debate Ramps Up in States as Congress Deadlocks
Abortion is a top issue for state lawmakers meeting for their first full sessions since Roe v. Wade was overturned.
By Julie Rovner As US Bumps Against Debt Ceiling, Medicare Becomes a Bargaining Chip
Episode 280The debt ceiling crisis facing Washington puts Medicare and other popular entitlement programs squarely on the negotiating table this year as newly empowered Republicans demand spending cuts. Meanwhile, as more Americans than ever have health insurance, the nationās health care workforce is straining under the load. Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, Tami Luhby of CNN, and Victoria Knight of Axios join KHNās chief Washington correspondent 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.
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Readers and Tweeters Diagnose Greed and Chronic Pain Within US Health Care System
KHN gives readers a chance to comment on a recent batch of stories.
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Medicare Pay Cuts Will Hurt Seniorsā Care, Doctors Argue
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.
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How Medicare Advantage Plans Dodged Auditors and Overcharged Taxpayers by Millions
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.
By Fred Schulte and Holly K. Hacker -
KHN Investigation: The System Feds Rely On to Stop Repeat Health Fraud Is Broken
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.
By Sarah Jane Tribble and Lauren Weber -
KHNās āWhat the Health?ā: Congress Races the Clock
Sen. Raphael Warnockās 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 KHNās 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.
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An Unexplained Injury Discovered After Eye Surgery. What Should Happen Next?
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. Hereās how patients can respond.
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Audits ā Hidden Until Now ā Reveal Millions in Medicare Advantage Overcharges
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.
By Fred Schulte and Holly K. Hacker -
Medicare Plan Finder Likely Wonāt Note New $35 Cap on Out-of-Pocket Insulin Costs
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.
By Susan Jaffe -
This Open Enrollment Season, Look Out for Health Insurance That Seems Too Good to Be True
Complaints about misleading health insurance marketing are soaring. State insurance commissioners are taking notice. Theyāve 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.
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Medicare Fines for High Hospital Readmissions Drop, but Nearly 2,300 Facilities Are Still Penalized
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.
By Jordan Rau -
Journalists Talk Medicare and Public Health Infrastructure
KHN and California Healthline staff made the rounds on national and local media this week to discuss their stories. Hereās a collection of their appearances.
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Hospitals Said They Lost Money on Medicare Patients. Some Made Millions, a State Report Finds.
A North Carolina state treasurerās 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.
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After Congress Fails to Add Dental Coverage, Medicare Weighs Limited Benefit Expansion
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.
By Susan Jaffe -
Lawsuit by KHN Prompts Government to Release Medicare Advantage Audits
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.
By Fred Schulte -
KHNās āWhat the Health?ā: Finally Fixing the ‘Family Glitch’
The Biden administration has decided to try to fix the so-called āfamily glitchā in the Affordable Care Act without an act of Congress. The provision has prevented workersā families from getting subsidized coverage if an employer offer is unaffordable. Meanwhile, Medicareās open enrollment period begins Oct. 15, and private Medicare Advantage plans are poised to cover more than half of Medicareās 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 KHNās 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.
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BMI: The Mismeasure of Weight and the Mistreatment of Obesity
The human body mass index ā a simple mathematical equation ā 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.