Category: Medicare

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.

New Medicare Advantage Plans Tailor Offerings to Asian Americans, Latinos, and LGBTQ+

As more seniors opt for Medicare Advantage, a few small insurers have begun offering plans that provide culturally targeted benefits for cohorts including Asian Americans, Latinos, and LGBTQ+ people. The approach, policy researchers say, has potential and perils.

KFF Health News’ ‘What the Health?’: More Medicaid Messiness

At least 30 states are reinstating coverage for children wrongly removed from the rolls under Medicaid redetermination, the federal government reported. It’s just the latest hiccup in the massive effort to review the eligibility of Medicaid beneficiaries now that the program’s pandemic-era expansion has expired. And federal oversight of the so-called unwinding would be further complicated by an impending government shutdown. Rachel Roubein of The Washington Post, Sandhya Raman of CQ Roll Call, and Sarah Karlin-Smith of Pink Sheet join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and more. Also this week, Rovner interviews KFF Health News’ Samantha Liss, who reported and wrote the latest KFF Health News-NPR “Bill of the Month” feature, about a hospital bill that followed a deceased patient’s family for more than a year.

What Happens to Health Programs if the Federal Government Shuts Down?

Medicare and Medicaid shouldn’t be affected, but confusion can be expected.

How Medicare’s New Drug Price Negotiation Program Could Expand Access to Selected Drugs

This brief examines how Part D enrollees’ access to and utilization of the first set of 10 selected drugs could be affected by the new Part D coverage and formulary requirements for selected drugs established by the Inflation Reduction Act and in CMS g…

KFF Health News’ ‘What the Health?’: Countdown to Shutdown

Congress appears to be careening toward a government shutdown, as a small band of House conservatives vow to block any funding for the fiscal year that begins Oct. 1 unless they win deeper cuts to health and other domestic programs. Meanwhile, former President Donald Trump continues to roil the GOP presidential primary field, this time with comments about abortion. Alice Miranda Ollstein of Politico, Rachel Cohrs of Stat, and Tami Luhby of CNN join KFF Health News chief Washington correspondent Julie Rovner to discuss these issues and more. Also, for “extra credit,” the panelists suggest health policy stories they read this week they think you should read, too.

KFF Health News’ ‘What the Health?’: Underinsured Is the New Uninsured

The annual U.S. Census Bureau report this week revealed a drop in the uninsured rate last year as more working-age people obtained employer coverage. However, this year’s end of pandemic-era protections — which allowed many people to stay on Medicaid — is likely to have changed that picture quite a bit since. Meanwhile, reports show […]

KFF Health News’ ‘What the Health?’: Welcome Back, Congress. Now Get to Work. 

Congress returns from its summer recess with a long list of tasks and only a few work days to get them done. On top of the annual spending bills needed to keep the government operating, on the list are bills to renew the global HIV/AIDS program, PEPFAR, and the community health centers program. Meanwhile, over the recess, the Biden administration released the names of the first 10 drugs selected for the Medicare price negotiation program.

The 4 Arguments You Will Hear Against Drug Price Negotiation

As the Biden administration begins the process of negotiation drug prices for Medicare as authorized in the Inflation Reduction Act, KFF’s Larry Levitt probes some of the arguments against it and the policy and political implications of the debate in t…

Biden Administration Proposes New Standards to Boost Nursing Home Staffing

The proposal would require major hiring at the most sparsely-staffed homes. But the proposal is already badly received by the nursing home industry which claims it can’t boost wages enough to attract workers.