Hospitals in New Mexico, Texas, and Oklahoma are among the first to apply for a new rural hospital payment model that shifts the focus of services away from overnight stays to outpatient and emergency care. Still, experts say the law needs to be amended to provide the right mix of care for rural communities.
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.
States are trying to reach millions of Medicaid enrollees to make sure those still eligible remain covered and help others find new health insurance.
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.
In a surprise decision, U.S. officials yield to insurance industry demands — at least for now.
KHN has released never-before-seen details of federal audits as the government weighs action against dozens of Medicare Advantage plans.
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.
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.
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.
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.
