Target Of Medicare Insider Trading Case Boasted He Was Unstoppable ‘Beast’
Prosecutors say hedge-fund traders made millions trading on information leaked from Medicare.
CMS
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Consumer Advocates Wary Of New Marketplace Rules For Brokers
Federal officials relaxed their rules this month about how brokers and insurers can work with individuals to apply for health law policies.
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CMS Gives States Until 2022 To Meet Medicaid Standards Of Care
The Trump administration has given states three more years to meet federal standards aimed at helping elderly and disabled Medicaid enrollees receive services without being forced to go into nursing homes.
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Navigating Aging
Drug Coverage Denied By Medicare? How Seniors Can Fight Back
Senior citizens have to be patient and keep close records to appeal when Medicare plans refuse to cover their medicines.
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Sen. Grassley Demands Scrutiny Of Medicare Advantage Plans
The powerful chairman of the Senate Judiciary Committee wants the Centers for Medicare and Medicaid Services to explain $125 million in overcharges by insurers.
By Fred Schulte -
CMS Chief To Sit Out Watershed Decision On Medicaid Work Mandate In Kentucky
Centers for Medicare & Medicaid Services Administrator Seema Verma will recuse herself from the agency's decision-making on whether to approve Kentucky’s Medicaid waiver because she helped develop the proposal in her former job as a health policy consultant.
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Justice Department Joins Lawsuit Alleging Massive Medicare Fraud By UnitedHealth
The Department of Justice is joining a whistleblower lawsuit in a fraud case against UnitedHealth in which damages could top $1 billion.
By Fred Schulte -
Repeal & Replace Watch
Health Law’s 10 Essential Benefits: A Look At What’s At Risk In GOP Overhaul
The woman set to run the federal Centers for Medicare & Medicaid Services told senators last week that maternity coverage should be optional in individual and small group plans. But other services could also be left on the cutting room floor.
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Docs Bill Medicare For End-Of-Life Advice As ‘Death Panel’ Fears Reemerge
The federal program paid $16 million in the first six months of 2016 to counsel 223,000 patients about treatment preferences in their last days.
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Repeal & Replace Watch
Five Quick Ways HHS Secretary Tom Price Could Change The Course Of Health Policy
After a tough fight by Democrats, Senate Republicans confirmed Rep. Tom Price’s nomination to head the Department of Health and Human Services. He will have the authority to upend some current practices.
By Julie Rovner -
Judge Accepts Medicare’s Plan To Remedy Misunderstanding On Therapy Coverage
Many seniors are denied coverage because therapists mistakenly believe that they must be making improvements to qualify for coverage.
By Susan Jaffe -
Medicare’s Coverage Of Therapy Services Again Is In Center Of Court Dispute
According to a settlement four years ago, Medicare was supposed to make clear to therapists that their services are covered even if beneficiaries are not improving. But that is not yet widely accepted.
By Susan Jaffe -
Repeal & Replace Watch
One Foot Out the Door, Medicare Chief Launches His Own Twitter Barrage
Acting CMS administrator Andy Slavitt is taking to social media to defend the Affordable Care Act from GOP dismantling.
By Rachel Bluth -
Medicare Failed To Recover Up To $125 Million In Overpayments, Records Show
Medicare overpaid five insurance plans by $128 million yet only recovered $3 million, audits show.
By Fred Schulte -
Bundled Payments Work, Study Finds, But HHS Nominee No Fan
A study found that Medicare’s bundled payments model for joint replacement could save the government billions of dollars without harming patient care.
By Rachel Bluth -
New Special Enrollment Rules Will Shift Paperwork Burden To Consumers
Federal officials provide details about a pilot project starting in June that will delay some consumers' mid-year marketplace enrollment until they produce documentation proving eligibility.
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Health Law’s Test Kitchen For Payment Reforms Could Offer Tool For GOP Ideas
The Centers for Medicare & Medicaid Innovation was charged by the health law with exploring payment reforms that could cut health care costs and possibly improve quality. But its future is hinged to whether GOP lawmakers see value in its work.
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Trump’s Pick To Run Medicare And Medicaid Has Red State Policy Chops
Seema Verma is a consultant who was Vice President-elect Mike Pence's health policy advisor when he was governor of Indiana, playing a key role in Medicaid expansion in that state.
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In Depressed Rural Kentucky, Worries Grow Over Medicaid
Low-income residents in poverty-stricken Clay County worry what will happen to their health care if Gov. Matt Bevin’s ambitions to overhaul the state’s Medicaid program go forward.
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Medicare Bars New ‘Seamless Conversion’ Efforts For Some Seniors
Some insurers have been allowed to move customers on the health law's marketplaces into their Medicare Advantage plans when they become eligible for Medicare, but seniors complain they didn’t always know it was happening.
By Susan Jaffe