A Covid Test Medicare Scam May Be a Trial Run for Further Fraud
Before the covid-19 public health emergency ended, Medicare advocates around the country noticed a rise in complaints from beneficiaries who received at-home covid tests they never requested. Bad actors may have used seniors’ Medicare information to improperly bill the federal government — and could do it again, say federal investigators.
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.
After Congress Fails to Add Dental Coverage, Medicare Weighs Benefit Expansion
Medicare can pay for some dental care if it is medically necessary to safely treat another covered medical condition, and federal officials have asked for suggestions on whether that list of conditions should be expanded.
Advantage Plans May Shorten Nursing Home Stays to Less Time Than Medicare Covers
Private Medicare Advantage health plans are increasingly ending coverage for skilled nursing or rehab services before medical providers think patients are healthy enough to go home, doctors and patient advocates say.
Medicaid Weighs Attaching Strings to Nursing Home Payments to Improve Care
The Biden administration is considering whether Medicaid, which pays the bills for 62% of nursing home residents, should require that most of that funding be used to provide care, rather than for maintenance, capital improvements, or profits.
Medicare Drug Plan Prices Touted During Open Enrollment Can Rise Within a Month
Even the savviest Medicare drug plan shoppers can get a shock when they fill prescriptions: That great deal on medications is no bargain after prices go up.
Seeking to Shift Costs to Medicare, More Employers Move Retirees to Advantage Plans
Private and public employers are increasingly using the government’s 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 “overwhelming majority” of medical costs, according to an industry analyst.
Medicare Patients Win the Right to Appeal Gap in Nursing Home Coverage
If federal officials accept a court’s decision, some patients will get a chance to seek refunds for their nursing home and other expenses.
Medicare’s Open Enrollment Is Open Season for Scammers
Medicare officials say complaints are rising from seniors lured into private plans with misleading information or enrolled without their consent. In response, officials have threatened to penalize the private companies selling Medicare Advantage and drug plans if they or agents working on their behalf mislead consumers.
3 States Limit Nursing Home Profits in Bid to Improve Care
Following the devastating impact of covid-19 on nursing homes, state lawmakers want to be sure that government and private payments primarily go to improve care and staffing.