Category: CMS

Feds Want a Policy That Advocates Say Would Let Hospitals Off the Hook for Covid-Era Lapses

The pandemic disrupted all sense of normalcy for U.S. hospitals, so federal officials are proposing to pause financial penalties against the facilities and to block public access to key hospital safety data — such as the frequency of falls and sepsis — because of concerns that the data isn’t accurate enough. But consumer advocates are furious about the proposal.

Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging

The Government Accountability Office and the Health and Human Services inspector general’s office say seniors enrolled in the program are suffering and taxpayers are getting bilked for billions of dollars a year.

Government Watchdogs Attack Medicare Advantage for Denying Care and Overcharging

The Government Accountability Office and the Health and Human Services inspector general’s office say seniors enrolled in the program are suffering and taxpayers are getting bilked for billions of dollars a year.

Buy and Bust: When Private Equity Comes for Rural Hospitals

Noble Health swept into two small Missouri towns promising to save their hospitals. Instead, workers and vendors say it stopped paying bills and government inspectors found it put patients at risk. Within two years — after taking millions in federal covid relief and big administrative fees — it locked the doors.

Medicaid Weighs Attaching Strings to Nursing Home Payments to Improve Patient Care

The Biden administration is considering whether Medicaid, which pays the bills for 62% of nursing home residents, should require that most of that funding be used to provide care, rather than for maintenance, capital improvements, or profits.

They Thought They Were Buying Obamacare Plans. What They Got Wasn’t Insurance.

Some consumers who think they are signing up for Obamacare insurance find out later they actually purchased a membership to a health care sharing ministry. But regulators and online advertising sites don’t do much about it.

Who Doesn’t Text in 2022? Most State Medicaid Programs

As states prepare for the end of the covid public health emergency, they are making plans to reevaluate each Medicaid enrollee’s eligibility. They will rely primarily on mail and email because not many states can text enrollees.

KHN’s ‘What the Health?’: Funding for the Next Pandemic

In his proposed budget, President Joe Biden called for a boost in health spending that includes billions of dollars to prepare for a future pandemic. But that doesn’t include money he says is needed immediately for testing and treating covid-19. Also this week, federal regulators authorized a second booster shot for people 50 and older yet gave little guidance to consumers about who needs the shot and when. Amy Goldstein of The Washington Post, Jennifer Haberkorn of the Los Angeles Times, and Rachana Pradhan of KHN join KHN’s Mary Agnes Carey to discuss these issues and more. Plus, Julie Rovner interviews KHN’s Julie Appleby, who reported and wrote the latest KHN-NPR “Bill of the Month” episode about a very expensive air ambulance ride.

Montana Is Sending Troubled Kids to Out-of-State Programs That Have Been Accused of Abuse

State health officials are using Medicaid funds to send children in their care to treatment programs in states with less stringent regulations, including programs accused of abuse and mistreatment.

Patients Divided Over Alzheimer’s Drug: Is It a ‘Risk I’m Willing to Take’ or Just a ‘Magic Pill’?

Medicare has proposed limiting coverage of Aduhelm, the costly new drug to treat Alzheimer’s disease, and several prominent groups representing patients and their families are pressing the program to make it more widely available. But among individuals facing the disease, the outlook is more nuanced.