Susan Jaffe covers health policy in Congress and the federal agencies for KHN and other publications.
Some physicians and patient advocates are concerned that the pursuit of lower Part B drug prices could endanger very sick Medicare Advantage patients if they can’t be treated promptly with the medicine that was their doctor’s first choice.
The NOTICE Act requires that starting Aug. 6, Medicare patients receive a form written in “plain language” after 24 hours of observation care but no later than 36 hours. Under the law, it must explain the reason they have not been admitted and how that decision will affect Medicare’s payment for services and patients’ share of the costs.
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
The report from the Government Accountability Office, said the backlog “shows no signs of abating.” It called for the Department of Health and Human Services to improve its oversight of the process and to streamline appeals so that prior decisions are taken into account and repetitive claims are handled more efficiently.
A dangerous fall does not have to be an inevitable part of aging. Risk-reduction programs are offered around the country.
Long observation stays, lasting 48 hours or more, rose by 450 percent to 170,219 during the same period, according to a Kaiser Health News analysis.
Medicare officials have allowed patients at dozens of hospitals participating in pilot projects across the country to be exempted from the controversial requirement that limits nursing home coverage to seniors admitted to a hospital for at least three days. The idea behind these experiments is to find out whether new payment arrangements with the hospitals […]
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
Federal officials are considering new Medicare Advantage rules to help protect seniors when insurers make significant reductions to their networks of doctors and other health care providers. The proposals follow UnitedHealthcare’s decision to drop thousands of doctors from its Medicare Advantage plans in at least 10 states last fall. The government’s response is part of […]
Federal efforts to strengthen inspections of the nation’s nursing homes are gaining momentum after a government probe uncovered instances of substandard care. The March 3 report by the HHS Inspector General found that an estimated one-third of residents suffered harm because of substandard care and that the chances of nursing home inspectors discovering these “adverse events” are […]
It used to be difficult for Edith Couturier, an 85-year-old resident of the District of Columbia, to explain to her adult children on the West Coast all the details of her medical appointments. But now she doesn’t go alone — she takes along a volunteer “medical note taker.” “There are four ears listening to what […]
In a decision that could have national implications, a Connecticut federal judge blocked UnitedHealthcare late Thursday from dropping an estimated 2,200 physicians from its Medicare Advantage plan in that state. The preliminary injunction issued by U.S. District Court Judge Stefan Underhill comes less than 48 hours before a deadline at midnight tomorrow for seniors to […]
We will highlight Build My Health's revenue practice management tools, which could help physician practices add up to $250,000 to their practices.
Dorathy Senay’s doctor had some bad news after her last checkup, but it wasn’t about her serious blood disorder called amyloidosis. Her Medicare Advantage managed care plan from UnitedHealthcare/AARP is terminating the doctor’s contract Feb. 1. She is also losing her oncologist at the prestigious Yale Medical Group — the entire 1,200 physician practice was […]
The U. S. Department of Labor issued new rules Tuesday that mandate home health care agencies pay their workers the minimum wage and receive overtime pay starting in 2015. "Almost 2 million home care workers are doing critical work, providing services...
A commission created by Congress to address the country’s surging need for long-term health care released recommendations Friday but did not reach a consensus on how to pay for these often expensive services. Home health aide Wendy Cerrato hel...
After reassuring seniors that Medicare is not part of the new health insurance marketplaces, administration officials have a warning for anyone who may have other ideas: selling marketplace coverage to people who have Medicare is illegal. Starting Jan...
While the Obama administration is stepping up efforts encouraging uninsured Americans to enroll in health coverage from the new online insurance marketplaces, officials are planning a campaign to convince millions of seniors to please stay away – don’t call and don’t sign up. “We want to reassure Medicare beneficiaries that they are already covered, their […]