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Los estados tienen hasta febrero para presentar sus planes de cancelación a los Centros de Servicios de Medicare y Medicaid federales, que supervisarán el proceso.

Los estados se están preparando para retirar a millones de personas de Medicaid a medida que expiren las protecciones implementadas durante la pandemia de COVID-19, lo que pone a millones de estadounidenses de bajos ingresos en riesgo de perder la cobertura de salud. Read more»

States have until February to submit their unwinding plans to the federal Centers for Medicare & Medicaid Services, which will monitor the process.

States are preparing to remove millions of people from Medicaid as protections put in place early in the COVID-19 pandemic expire - putting millions of low-income Americans at risk of losing health coverage and threatening their access to care. Read more»

Since 2010, the federal Centers for Medicare & Medicaid services has threatened to crack down on billing abuses in the popular health plans, which now cover more than 30 million Americans.

Medicare Advantage plans for seniors dodged a major financial bullet as government officials gave them a reprieve for returning hundreds of millions of dollars or more in government overpayments — some dating back a decade or more. Read more»

Federal law requires emergency departments at Medicare-participating hospitals to care for anyone who shows up, but the lack of clear guidelines on enforcement of the law sometimes stops emergency department doctors from redirecting patients to more appropriate facilities.

People who are injured or sick are asked, in a moment of stress, to prudently decide which medical setting is the best place to seek help, but revenue-driven operators of alternatives to hospital emergency rooms have little incentive to make the process easier for patients. Read more»

While hospital volunteer programs across the country reboot after the pandemic, labor experts say using volunteers may expose some medical facilities to liability.

At hospitals across the U.S., volunteers play an integral role, and the health system benefits from potentially more than $5 billion in free labor annually - but using volunteers, particularly at for-profit institutions, provides an opportunity for facilities to run afoul of federal rules. Read more»

Dr. Theresa Cullen, Pima County's health director, was chosen to take over ADHS, replacing Don Herrington, who has been the interim director since Aug. 26, 2021, shortly after Dr. Cara Christ left the position. Christ made her exit at a time when Gov. Doug Ducey held his stance against a statewide mask mandate despite CDC recommendations to mask and rising COVID case numbers.

Across the country, health officials have been trying to combat misinformation and restore trust within their communities these past few years, a period when many people haven’t put full faith in their state and local health departments. Read more»

The cost-estimator tools could be useful for the increasing number of people with high-deductible health plans who pay directly out-of-pocket for much of their health care before they hit that deductible.

As of Jan. 1, health insurers and employers that offer health plans must provide online calculators for patients to get detailed estimates of what they will owe — taking into account deductibles and copayments — for a range of services and drugs. Read more»

Una puerta cerrada con llave en la frontera en Nogales. La atención médica en los centros de detención de inmigrantes era deficiente incluso antes de la pandemia y en septiembre expiró una orden judicial que requería que los funcionarios federales de inmigración consideraran la liberación de los detenidos con riesgos de COVID.

Para aproximadamente 30,000 personas que viven en espacios cerrados en la red de instalaciones de inmigración del país, COVID sigue siendo una amenaza siempre presente. Read more»

A locked gate at the border in Nogales. Medical care in immigration detention facilities was deficient even before the pandemic and in September, a court order expired that required federal immigration officials to consider releasing detainees with COVID risks.

Across the country, the chance of developing severe illness or dying from COVID has fallen - but for the roughly 30,000 people living in close quarters in the country’s network of immigration facilities, COVID remains an ever-present threat. Read more»

Private equity-backed firms have been attracted to emergency rooms in recent years because ERs are profitable and because they have been able to charge inflated amounts for out-of-network care.

A group of emergency physicians and consumer advocates in multiple states are pushing for stiffer enforcement of decades-old statutes that prohibit the ownership of medical practices by corporations not owned by licensed doctors. Read more»

Medicare reimburses Medicare Advantage plans using a complex formula called a risk score that computes higher rates for sicker patients and lower ones for healthier people - but federal officials rarely demand documentation to verify that patients have these conditions.

A review of 90 government audits reveals that health insurers that issue Medicare Advantage plans have repeatedly tried to sidestep regulations requiring them to document medical conditions the government paid them to treat. Read more»

Although the federal government doesn’t track who’s gotten the drug, a Centers for Disease Control and Prevention study using data from 30 medical centers found that Black and Hispanic patients with COVID were much less likely to receive Paxlovid than white patients.

Nearly 6 million Americans have taken Paxlovid - which helped prevent many people infected with COVID-19 from being hospitalized or dying - courtesy of the federal government, but the government plans to stop footing the bill within months, and millions may have to pay the full price. Read more»

The Centers for Disease Control and Prevention headquarters in Atlanta.

Earlier this year, top leadership at the Centers for Disease Control and Prevention began the task of reforming the agency, but the current workplace structure could be a major barrier as the agency has embraced a workplace program that allows most of its scientists to stay remote. Read more»

Because the nation’s roughly 28,900 assisted living communities are regulated by states and there are no federal standards, practices vary widely and generally there are fewer protections for residents than are found in nursing homes.

Assisted living communities too often fail to meet the needs of older adults and should focus more on residents’ medical and mental health concerns - changes inspired by the altered profile of the population that assisted living now serves. Read more»

CMS has completed only 90 audits over the past decade, a time when Medicare Advantage has grown explosively.

Newly released federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage health plans for seniors, with some plans overbilling the government more than $1,000 per patient a year on average. Read more»

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