Category: CMS

KFF Health News’ ‘What the Health?’: Courts Try To Curb Health Cuts

Some of the Trump administration’s dramatic funding and policy shifts are facing major pushback for the first time — not from Congress, but from the courts. Federal judges around the country are attempting to pump the brakes on efforts to freeze government spending, shut down the U.S. Agency for International Development, eliminate access to health-related webpages and datasets, and limit grant funding provided by the National Institutes of Health. Meanwhile, Congress is off to a slow start in trying to turn President Donald Trump’s agenda into legislation, although Medicaid is clearly high on the list for potential funding cuts. Shefali Luthra of The 19th, Jessie Hellmann of CQ Roll Call, and Maya Goldman of Axios News join KFF Health News’ Julie Rovner to discuss these topics and more. Also this week, Rovner interviews Mark McClellan, director of the Duke-Margolis Institute for Health Policy and a former health official during the George W. Bush administration, about the impact of cutting funding to research universities.

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.

Obamacare Sign-Ups Lag After Trump Election, Legal Challenges

The number of new and returning enrollees using healthcare.gov — the federal marketplace that serves 31 states — is well below last year’s as of early December. Also, a Biden administration push to give “Dreamers” access to Obamacare coverage and subsidies is facing court challenges.

Anti-Fraud Efforts Meet Real-World Test During ACA Enrollment Period

The federal government put guardrails in place to limit unauthorized plan sign-ups and switches. But the changes could prove to be a burden to consumers.

Readers Embrace ‘Going It Alone’ Series on Aging and Chastise Makers of Pulse Oximeters

KFF Health News gives readers a chance to comment on a recent batch of stories.

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.

KFF Health News’ ‘What the Health?’: Trump’s Nontraditional Health Picks

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 KFF 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.

KFF 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.

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.

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.