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Breakups between health providers and Advantage plans are increasingly common. The Centers for Medicare & Medicaid Services has allowed whole groups of patients to leave their plans.
When Congress returns next week, it will be writing a budget reconciliation bill that’s expected to cut taxes but also make deep cuts to Medicaid. But at least some Republicans are concerned about cutting a program that aids so many of their constituents. Sarah Karlin-Smith of the Pink Sheet, Tami Luhby of CNN, and Alice Miranda Ollstein of Politico join ³Ô¹Ï²»´òìÈ’ Julie Rovner to discuss this story and more. Also, Rovner interviews ³Ô¹Ï²»´òìÈ’ Rae Ellen Bichell about her story on how care for transgender minors is changing in Colorado.
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Some rural hospitals have canceled — or are considering ending — contracts with insurance companies that offer Medicare Advantage plans, saying the private policies jeopardize their finances and impede patient care.
A special master found the Justice Department failed to prove wrongdoing by the giant health insurer.
A whistleblower suit alleged a health insurer bilked Medicare by exaggerating how sick patients were.
Celebrity doctor Mehmet Oz recently held broad investments in health care, tech, and food companies. Were he confirmed to run the Centers for Medicare & Medicaid Services, his job would involve interacting with giants of the industry that have contributed to his wealth.
Not only has President-elect Donald Trump chosen prominent vaccine skeptic Robert F. Kennedy Jr. to lead the Department of Health and Human Services, Trump also has said he will nominate controversial TV host Mehmet Oz to run the Centers for Medicare & Medicaid Services, which oversees coverage for nearly half of Americans. Meanwhile, the lame-duck Congress is back in Washington with just a few weeks to figure out how to wrap up work for the year. Rachel Cohrs Zhang of Stat, Sandhya Raman of CQ Roll Call, and Riley Ray Griffin of Bloomberg News join ³Ô¹Ï²»´òìÈ’ Julie Rovner to discuss these stories and more. Also this week, Rovner interviews Sarah Varney, who has been covering a trial in Idaho challenging the lack of medical exceptions in that state’s abortion ban.
Freedom of Information Act case targets HHS inspector general’s reviews of billions of dollars in health plan overpayments.
Medicare officials defend the use of home visits that often spot medical conditions that are never treated.
Democrats and conservatives are divided over whether the federal health program for people over 65 should be run almost entirely by the private sector. If Trump retakes the White House, the shift to Medicare Advantage may accelerate.
Experts disputed the claim by Republican vice presidential candidate JD Vance, noting that a range of other issues — from low reimbursement rates to declining patient use — combine to cause these facilities to shutter.
Uber and Lyft have become a critical part of the nation’s infrastructure for transporting ailing people from their homes — even in rural areas — to medical care sites in major cities such as Atlanta.
New court filings and lobbying reports reveal an industry drive to tamp down critics — and retain billions of dollars in overcharges.
A private 2014 decision by the Centers for Medicare & Medicaid Services faces new scrutiny in a multibillion-dollar Justice Department fraud case against UnitedHealth Group.
Healthcare in Action, a California medical group that exclusively serves homeless people, has tapped into growing demand and funding for street medicine services. Three years in, the innovative nonprofit is raking in revenue and serving thousands of people who otherwise might flock to the hospital for high-cost care.
President Joe Biden is campaigning for reelection on his efforts to cut costs for Medicare patients at the pharmacy counter. But independent pharmacists say one strategy makes it unaffordable for them to keep some brand-name medicines in stock.
Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. There’s a way out.
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