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Federal officials are planning a wide range of audits into billing and government spending on managed health care in the new fiscal year, ranging from private Medicare Advantage groups that treat millions of elderly to health plans rapidly expanding under the Affordable Care Act.
On Wednesday, Medicare officials agreed to pay for Glenda Jimmo鈥檚 home health care, reversing an earlier denial that said she didn鈥檛 qualify for coverage because she was not improving.
The order follows a Kaiser Health News report detailing three fatal cases in which sources say recommended nursing home citations were downgraded.
Patient advocates say that, because of an official coverage reminder 鈥渢he door is closing鈥 for ALS patients who depend on Medicare to get speech-generation devices.
Kaiser Health News' Julie Rovner hosted a webinar Tuesday to provide background to reporters covering Medicare Advantage and Part D issues through open enrollment and beyond.
The landmark settlement was supposed to be a victory for Medicare beneficiaries with chronic conditions and disabilities who had been denied coverage for skilled care because they didn鈥檛 meet 鈥渢he improvement standard鈥 鈥 meaning they were unlikely to improve. But when Glenda Jimmo was denied coverage this spring for that same reason, her lawyers filed a second lawsuit.
An investigation by the HHS inspector general says beneficiaries getting the treatments at "critical access" hospitals pay between two and six times more than those at other hospitals.
A consumer reporter shares what she learned when getting ready to join the federal health plan for seniors.
Although fewer patients are now returning to the hospital within a month, the fines reached a record level this year.
Medicare evaluated the readmission rates of the nation's hospitals in determining the third year of penalties in the Hospital Readmissions Reduction Program. This table lists the average impact on hospitals in each state.
The methodology behind KHN's analysis of the third year of the Medicare penalty program.
Kaiser Health News consumer columnist gives readers some basic information to help them weigh their Medicare options.
A quarter of the nation's hospitals are exempt from penalties, quality bonuses and other payment reforms.
Some of a hospital's income now depends on keeping patients healthy. Kevin Wiehrs seeks to save hospitals money by keeping former patients out of the hospital.
Among the most significant difference is that patient with their own insurance don't face the same danger of losing nursing home coverage.
Federal actuaries say the economic rebound and increasing number of people with insurance will push up spending.
When Congress created the option for beneficiaries to join the private Medicare Advantage plans, it gave oversight to federal officials, preempting state insurance laws and procedures.
A study of Medicare billing found that many dermatology procedures were done by nurse practitioners and physician assistants.
Letters to the Editor is a regular feature in which readers comment on KHN original stories.
FDA and Medicare officials conduct a parallel review of a new screening test for colorectal cancer and that could bring the test to beneficiaries six months faster.
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