Investigation On Medicare Advantage Plans Finds Widespread, Persistent Problems Related To Denials Of Care
The investigation by the HHS inspector general raises some concerns just as Medicare Advantage plans become more and more popular. Analysts predict that one in two seniors will have them in a few years despite predictions that the health law would hobble the marketplace.
The New York Times:
Medicare Advantage Plans Found To Improperly Deny Many Claims
Medicare Advantage plans, the popular private-insurance alternative to the traditional Medicare program, have been improperly denying many medical claims to patients and physicians alike, federal investigators say in a new report. The private plans, which now cover more than 20 million people — more than one-third of all Medicare beneficiaries — have an incentive to deny claims “in an attempt to increase their profits,” the report says. (Pear, 10/13)
In other national health care news —
The New York Times:
Inside The Vast Tent City Housing Migrant Children In A Texas Desert
On a barren patch of desert near the border, the incident commander stepped into the Incident Command Post trailer. Walkie-talkies were charging in the corner. Flat-screen TVs and computer monitors showed surveillance camera footage and weather forecasting models. The 911 dispatch center, in a nearby trailer, was quiet, and so were the ambulances and fire trucks. (Fernandez and Dickerson, 10/12)
Politico:
Trump Set To Force Drugmakers To Post Prices In Ads
The Trump administration will require drug companies to post their list prices in consumer ads under a proposal to be announced next week — a prominent part of its drug price agenda, according to four individuals with knowledge of the plan. The move — which follows months of battles between the administration, congressional leaders and the pharmaceutical industry — is one of many proposals in President Donald Trump's blueprint to lower drug prices. But experts caution that the impact may be relatively insignificant and it could even confuse patients, considering the complexities of drug pricing. (Diamond and Karlin-Smith, 10/12)
The New York Times:
Code Name Jane: The Women Behind A Covert Abortion Network
The no-frills advertisement, printed at times in student and alternative newspapers, went straight to the point: “Pregnant? Don’t want to be? Call Jane.” A telephone number followed. This was nearly half a century ago, when abortion was illegal almost everywhere in the country and alternative newspapers were in their heyday. There was no Jane, though, not literally anyway. Yet at the same time, Jane was anybody. (Haberman, 10/14)
The New York Times/ProPublica:
Sloan Kettering Researchers Correct The Record By Revealing Company Ties
Top researchers at Memorial Sloan Kettering Cancer Center have filed at least seven corrections with medical journals recently, divulging financial relationships with health care companies that they did not previously disclose. The hospital’s chief executive, Dr. Craig B. Thompson, disclosed his relationship with companies including the drug maker Merck, and Dr. Jedd Wolchok, a noted pioneer in cancer immunotherapy, listed his affiliations with 31 companies. (Ornstein and Thomas, 10/12)
Stat:
The Fertility Business Is Growing, And So Is Investor Interest
The field of fertility medicine is booming right now. Women are waiting longer and longer to have children. Same-sex couples looking to start families are increasingly turning to in vitro fertilization. And investors are pouring money into startups pitching egg freezing and genetic testing and other services to young women.There are few observers more qualified to weigh in on this business than Dr. David Sable. Sable previously spent years as an IVF doctor and now he invests in biotech on Wall Street, as a portfolio manager for the firm Special Situations. (Robbins, Feuerstein and Garde, 10/12)