Latest California Healthline Stories
How Medicare Advantage Plans Dodged Auditors, Overcharged Taxpayers by Millions
Facing rare scrutiny from federal auditors, some Medicare Advantage health plans failed to produce any records to justify their payments, government records show. The audits revealed millions of dollars in overcharges to Medicare over three years.
KHN Investigation: The System Feds Rely On to Stop Repeat Health Fraud Is Broken
A months-long KHN examination of the system meant to bar fraudsters from Medicaid, Medicare, and other federal health programs found gaping holes and expansive gray areas through which banned individuals slip to repeatedly bilk taxpayer-funded programs.
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.
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.
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.
Lawsuit by KHN Prompts Government to Release Medicare Advantage Audits
The lawsuit was filed three years ago to learn about vast overcharges by the popular health plans that are detailed in audits the government refused to release to the public.
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.
Surveys Earn a Zero on Tracking Whether Hospitals Deliver Culturally Competent Care
In an industry obsessed with consumer satisfaction national patient surveys still don’t get at an important question: Are hospitals delivering culturally competent care?
Rapper Fat Joe Says No One Is Making Sure Hospitals Post Their Prices
A TV and social media ad offers a reason to check on the enforcement of a sweeping rule that requires hospitals to post information about what they charge insurers and cash-paying patients.