Category: CMS

Idaho Dropped Thousands From Medicaid in the Pandemic’s First Years

The removals, detailed in emails between state and federal health officials, hinged on disagreements over how states could disenroll people during the public health emergency. Consumer advocates fear the alleged violation signals the mess to come on April 1, when the pandemic-era Medicaid coverage mandate ends.

As Pandemic-Era Medicaid Provisions Lapse, Millions Approach a Coverage Cliff

States are trying to reach millions of Medicaid enrollees to make sure those still eligible remain covered and help others find new health insurance.

Nursing Home Owners Drained Cash During Pandemic While Residents Deteriorated

As the federal government debates whether to require higher staffing levels at nursing homes, financial records show owners routinely push profits to sister companies while residents are neglected. “A dog would get better care than he did,” one resident’s wife said.

Government Lets Health Plans That Ripped Off Medicare Keep the Money

In a surprise decision, U.S. officials yield to insurance industry demands — at least for now.

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.

Medicare Pay Cuts Will Hurt Seniors’ 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.

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.

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.

KHN’s ‘What the Health?’: Congress Races the Clock

Sen. Raphael Warnock’s 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’s 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.

Audits — Hidden Until Now — 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.