Category: CMS

KFF Health News’ ‘What the Health?’: Nursing Home Staffing Rules Prompt Pushback

The nursing home industry — as well as a healthy number of Congress members — are all pushing back on the Biden administration’s new rules on nursing home staffing. Industry officials say that there are not enough workers to meet the requirements and that the costs would be prohibitive. Meanwhile, Democrats on Capitol Hill are trying to force Republicans to explain their exact positions on assuring access to contraceptives and in vitro fertilization. Rachel Cohrs Zhang of Stat, Alice Miranda Ollstein of Politico, and Sandhya Raman of CQ Roll Call join KFF Health News’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews KFF Health News’ Bram Sable-Smith, who reported and wrote the latest KFF Health News-NPR “Bill of the Month” feature about a free cruise that turned out to be anything but.

Exclusive: Senator Urges Biden Administration To Thwart Fraudulent Obamacare Enrollments

With tens of thousands of Americans already affected by enrollment scams that leave some without doctors or treatments, Oregon Sen. Ron Wyden wants increased enforcement against rogue agents or other perpetrators and legislation to allow for criminal penalties.

Exclusive: Senator Urges Biden Administration To Thwart Fraudulent Obamacare Enrollments

With tens of thousands of Americans already affected by enrollment scams that leave some without doctors or treatments, Oregon Sen. Ron Wyden wants increased enforcement against rogue agents or other perpetrators and legislation to allow for criminal penalties.

Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don’t Meet Them.

The staffing regulation was disparaged by the industry as unattainable. Patient advocates say it doesn’t go far enough. Labor unions welcomed the requirement.

Lawsuit Alleges Obamacare Plan-Switching Scheme Targeted Low-Income Consumers

The lawsuit filed in federal court alleges that large call centers were used to enroll people into Affordable Care Act plans or to switch their coverage, all without their permission.

When Rogue Brokers Switch People’s ACA Policies, Tax Surprises Can Follow

Some tax filers’ returns are being rejected because they failed to provide information about Affordable Care Act coverage they didn’t even know they had.

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.

Readers Slam Hospital Monopolies and Blame the Feds for Understaffed Nursing Homes

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

Lost in the Mix of Medicaid ‘Unwinding’: Kentucky Cut Off Her Health Care Over a Clerical Error

The state canceled Beverly Likens’ coverage — days before surgery — without considering other ways she qualified for Medicaid, which experts say violated federal regulations.

Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients

Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and then predicts what kind of care an individual will need and for how long. New federal rules will ensure human experts are part of the process.