Category: Medicare

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.

Medical “Advantage” for my indigent patients

Despite the aggressive marketing, Medicare Advantage plans offer little benefit for poor and vulnerable patients. Consider my patient C, who was in pain from her knee arthritis. She was often in pain, but now her new pain medication helped her less tha…

An Unexplained Injury Discovered After Eye Surgery. What Should Happen Next?

Some doctors and medical practices voluntarily give rebates on a bill if an injury occurs during a procedure, while others will not, an expert says. Here’s how patients can respond.

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.

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.

Medicare Plan Finder Likely Won’t Note New $35 Cap on Out-of-Pocket Insulin Costs

In August, Congress approved a $35 cap on what seniors will pay for insulin, but that change came too late to add to the online tool that helps Medicare beneficiaries compare dozens of drug and medical plans. Federal officials say beneficiaries who use insulin will have the opportunity to switch plans after open enrollment ends Dec. 7.

This Open Enrollment Season, Look Out for Health Insurance That Seems Too Good to Be True

Complaints about misleading health insurance marketing are soaring. State insurance commissioners are taking notice. They’ve created a shared internal database to monitor questionable business practices, and, in the future, they hope to provide a public-facing resource for consumers. In the meantime, consumers should shop wisely as open enrollment season begins.

Medicare Fines for High Hospital Readmissions Drop, but 2,300 Facilities Are Still Penalized

Federal officials said they are penalizing 2,273 hospitals, the fewest since the fiscal year that ended in September 2014. Driving the decline was a change in the formula to compensate for the chaos caused by the covid-19 pandemic.

Hospitals Said They Lost Money on Medicare Patients. Some Made Millions, a State Report Finds.

A North Carolina state treasurer’s report found hospitals give conflicting information about whether they profit from Medicare patients. Experts said the findings are significant because they suggest the federal government has failed to closely watch the billions of dollars in tax breaks that nonprofit hospitals have received.

Public Opinion on Prescription Drugs and Their Prices

This chart collection draws on recent KFF poll findings to provide an in-depth look at the public’s attitudes toward prescription drugs and their prices. Results include Americans’ opinions on drug affordability, pharmaceutical companies, and various p…