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As states prepare for the end of the covid public health emergency, they are making plans to reevaluate each Medicaid enrollee鈥檚 eligibility. They will rely primarily on mail and email because not many states can text enrollees.
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鈥檛 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鈥檚 Mary Agnes Carey to discuss these issues and more. Plus, Julie Rovner interviews KHN鈥檚 Julie Appleby, who reported and wrote the latest KHN-NPR 鈥淏ill of the Month鈥 episode about a very expensive air ambulance ride.
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.
Medicare has proposed limiting coverage of Aduhelm, the costly new drug to treat Alzheimer鈥檚 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.
Private and public employers are increasingly using the government鈥檚 Medicare Advantage program as an alternative to their existing retiree health plan and traditional Medicare coverage. As a result, the federal government is paying the 鈥渙verwhelming majority鈥 of medical costs, according to an industry analyst.
CMS chief Chiquita Brooks-LaSure says the agency reserves its power to quickly institute new regulations for 鈥渁bsolute emergencies.鈥 On staffing, nursing home residents might need to wait years to see any real change.
Almost a year after the American Rescue Plan Act allocated what could amount to $25 billion to home and community-based services run by Medicaid, many states have yet to access much of the money due to delays and red tape.
The president wants to set minimum staffing levels for the beleaguered nursing home industry. But, given a lack of transparency surrounding the industry鈥檚 finances, it鈥檚 a mystery how facilities will shoulder the added costs.
An epic battle is playing out behind the scenes over whether the government should pay for Aduhelm, an FDA-approved Alzheimer鈥檚 drug that scientists say has not been proven to work.
State Medicaid agencies for months have been preparing for the end of a federal mandate that has prevented states from removing people from the safety-net program during the pandemic.
Congress is set to start its once-every-five-years review of the law that authorizes user fees to finance the hiring of personnel to speed the FDA review of drugs. The periodic renewals of 鈥淧DUFA鈥 also give lawmakers a chance to make other changes to the agency at the hub of the pandemic. Meanwhile, the FDA could also find itself at the center of the abortion debate and a controversial new medication to treat Alzheimer鈥檚 disease. Anna Edney of Bloomberg News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico, and Sarah Karlin-Smith of the Pink Sheet join KHN鈥檚 Julie Rovner to discuss these issues and more.
The Biden administration is getting rid of several policies implemented by Trump-era appointees that restricted enrollment. Federal officials now say states can no longer charge premiums to low-income residents enrolled in Medicaid and have ruled out work requirements.
Among the 764 hospitals hit with a 1% reduction in Medicare payments this year for having high numbers of patient infections and avoidable complications are more than three dozen that Medicare also ranks as among the best in the country.
As omicron surges, more nursing homes are facing a double whammy: Lab tests are taking too long, and fast antigen tests are in short supply.
If federal officials accept a court鈥檚 decision, some patients will get a chance to seek refunds for their nursing home and other expenses.
Relatives say it is important they be allowed to go into nursing homes because staff shortages are affecting care. And many are still upset about lengthy separations from loved ones during lockdowns earlier in the pandemic.
The court is considering whether to let the rules go into effect as opponents fight them in lower courts. Conservative justices pressed lawyers hard about whether the administration overstepped its authority, but liberal members of the high court questioned why the government shouldn鈥檛 be expected to move forcefully when facing a severe health crisis.
Facility fees, designed to help hospitals cover the high cost of staying open 24/7, have long rankled consumers. Now, some patients are assessed the fees while sitting at home for a telehealth appointment.
California wants to hold nursing homes accountable for the quality of care they provide by tying Medicaid funding more directly to performance. But the nursing home industry, an influential player in the Capitol, is gearing up for a fight.
Medicare billing codes for audio-only follow-up check-ins lead to new reimbursement battles.
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