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Medicare Advantage patients find themselves in regulatory limbo

Medicare pays the privately run health plans — an alternative to traditional Medicare — a set monthly rate for each patient. About 16 million Americans have signed up at an annual cost to taxpayers of more than $160 billion, about one third of the elderly and disabled people eligible for Medicare. A Center for Public Integrity investigation published in June found as much as $70 billion of improper payments to Medicare Advantage plans from 2008 through last year.... Read more»

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Obamacare: A midterm report card

The first half of the Obamacare open enrollment period is over, and yesterday, federal health officials announced sign-up figures from the first three months. ... Read more»

Reid overstates reduction in uninsured

Senate Majority Leader Harry Reid incorrectly claimed that 9 million Americans “have health care that didn’t have it before” because of the Affordable Care Act. That figure includes an unknown number who previously had insurance but switched to a policy sold through the exchanges, plus an unknown number of Medicaid recipients who renewed their coverage.... Read more»

In a major shift, Medicare wants power to ban harmful prescribers

Medicare plans to arm itself with broad new powers to better control — and potentially ban — doctors engaged in fraudulent or harmful prescribing, following a series of articles by ProPublica detailing lax oversight in its drug program. ... Read more»

HealthCare.gov’s mysterious new number: ‘834’

Now that the front-end of HealthCare.gov appears to be working properly, the media’s focus is quickly shifting to the back-end systems that are supposed to provide insurance companies with accurate information about consumers enrolling in their plans.... Read more»

Consumer Reports on healthcare.gov

GOP Majority Whip Kevin McCarthy falsely claimed Consumer Reports warned “Americans not to go to the [HealthCare.gov] website because of the fear of having fraud.” The consumer advocate initially advised people to wait until the website’s many technical problems were worked out, but it told us that its advice “was not in reference to any concerns regarding fraud.”... Read more»

Why health insurance cancellations shouldn’t be a surprise

There seems to be no letup of bad news on the Affordable Care Act. Yesterday, Healthcare.gov, the problem-plagued federal health insurance marketplace, crashed again. And a pile of news reports focused on citizen anger over policy cancellations prompted by the law. ... Read more»

A tale of two Obamacares: Which Is right?

This weekend, I read two very different takes on the three-week-old Healthcare.gov health insurance marketplace. One was hopeful; the other decidedly not. Both are worth your time. ... Read more»

Obamacare myths

We’ve been batting down bogus claims about the Affordable Care Act for years, since 2009, when legislation was still in the debate stage. But they’ve been increasing in intensity in recent months as we approach Oct. 1, the date the insurance exchanges will be open for business for those buying their own insurance, mainly with the help of federal subsidies.... Read more»

Feds propose shakeup for emergency room billing

Federal officials for more than a decade have let hospitals decide on their own how much to charge Medicare for certain emergency room overhead and staffing costs called “facility” fees — a controversial policy some critics believe invites overcharges. Now in a major turnabout, the Centers for Medicare and Medicaid Services are seeking tighter controls over the fees as part of a plan to redirect billions of dollars Medicare spends annually on outpatient health care. ... Read more»

Louie Gohmert’s health care hooey

Rep. Louie Gohmert is wrong when he says a “poor guy out there making $14,000″ is “going to pay extra income tax if he cannot afford to pay the several thousand dollars for an Obamacare policy.” In fact, that “poor guy” will be eligible for Medicaid coverage or heavily subsidized private insurance, depending on where he lives, without fear of being penalized if he cannot afford insurance. ... Read more»

Obama overhypes health savings

President Barack Obama presented a glowing but incomplete view of how much Americans can save on premiums thanks to the Affordable Care Act.... Read more»

The 10 most common nursing home violations

ProPublica today is updating our Nursing Home Inspect tool, which now includes details of more than a quarter-million deficiencies identified by government regulators at U.S. nursing homes over the past three years.... Read more»

States find obstacles moving elderly, disabled into community

A multi-billion dollar federal initiative to move low-income elderly and disabled people from long-term care facilities into the community has fallen far short of its goals.... Read more»

Medicare adds new accountable care organizations

The Obama administration announced Tuesday that 27 health systems have been selected to participate in Medicare’s Shared Savings Program.... Read more»

State gets go-ahead for more Medicaid changes

The federal government Friday approved a handful of changes to Arizona’s Medicaid program that state officials said could help extend health coverage to more than 20,000 low-income children.... Read more»

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