In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M
A whistleblower suit alleged a health insurer bilked Medicare by exaggerating how sick patients were.
Medicare
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Readers Embrace ‘Going It Alone’ Series on Aging and Chastise Makers of Pulse Oximeters
吃瓜不打烊 gives readers a chance to comment on a recent batch of stories.
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TV鈥檚 Dr. Oz Invested in Businesses Regulated by Agency Trump Wants Him To Lead
Celebrity doctor Mehmet Oz recently held broad investments in health care, tech, and food companies. Were he confirmed to run the Centers for Medicare & Medicaid Services, his job would involve interacting with giants of the industry that have contributed to his wealth.
By Darius Tahir Trump鈥檚 Nontraditional Health Picks
Episode 373Not only has President-elect Donald Trump chosen prominent vaccine skeptic Robert F. Kennedy Jr. to lead the Department of Health and Human Services, Trump also has said he will nominate controversial TV host Mehmet Oz to run the Centers for Medicare & Medicaid Services, which oversees coverage for nearly half of Americans. Meanwhile, the lame-duck Congress is back in Washington with just a few weeks to figure out how to wrap up work for the year. Rachel Cohrs Zhang of Stat, Sandhya Raman of CQ Roll Call, and Riley Ray Griffin of Bloomberg News join 吃瓜不打烊鈥 Julie Rovner to discuss these stories and more. Also this week, Rovner interviews Sarah Varney, who has been covering a trial in Idaho challenging the lack of medical exceptions in that state鈥檚 abortion ban.
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California Sets 15% Target for Primary Care Spending Over Next Decade
The state Office of Health Care Affordability has set a goal for insurers to direct 15% of their spending to primary care by 2034, part of a push to expand preventive care services. Health plans say it鈥檚 unclear how the policy will mesh with the state鈥檚 overarching goal to slow spending growth.
Readying for Republican Rule
Episode 372With Republicans now set to control the White House, Senate, and House of Representatives starting in January, their health agenda remains unclear. What is clear, however, is that just about anything could be on the table, from Medicare, Medicaid, and the Affordable Care Act, to drug prices and public health. Meanwhile, anti-abortion groups are preparing to fight the implementation of abortion rights ballot measures just passed by voters in seven states. Rachel Roubein of The Washington Post, Anna Edney of Bloomberg News, and Lauren Weber of The Washington Post join 吃瓜不打烊鈥 Julie Rovner to discuss these stories and more. Plus, for 鈥渆xtra credit,鈥 the panelists suggest health policy stories they read this week that they think you should read, too.
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吃瓜不打烊 Sues To Force Disclosure of Medicare Advantage Audit Records
Freedom of Information Act case targets HHS inspector general鈥檚 reviews of billions of dollars in health plan overpayments.
By Fred Schulte -
Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits
Medicare officials defend the use of home visits that often spot medical conditions that are never treated.
By Fred Schulte -
Trump鈥檚 White House Return Poised To Tangle Health Care Safety Net
The new Trump administration is likely to reduce subsidies for Affordable Care Act insurance plans and roll back Medicaid coverage. Public health authorities worry that anti-vaccine activist Robert F. Kennedy Jr. will be empowered.
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In Vermont, Where Almost Everyone Has Insurance, Many Can鈥檛 Find or Afford Care
Vermont has one of the lowest uninsured rates in the U.S., even though its residents pay some of the highest health insurance costs. Still, most of its hospitals are losing money and patients often face long waits for care.
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Election Outcome Could Bring Big Changes to Medicare
Democrats and conservatives are divided over whether the federal health program for people over 65 should be run almost entirely by the private sector. If Trump retakes the White House, the shift to Medicare Advantage may accelerate.
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Trump Wants Harris To Pay a Political Price for Generous Immigrant Health Policies
Several Democratic-led states have expanded public insurance programs to cover immigrants in the U.S. regardless of legal status. Donald Trump is trying to blame Kamala Harris for the policies.
By Joanne Kenen The Campaign鈥檚 Final Days
Episode 370It鈥檚 the final days of the 2024 campaign, and Republicans are suddenly talking again about making changes to the Affordable Care Act if former President Donald Trump wins. Meanwhile, new reporting uncovers more maternal deaths under state abortion bans 鈥 and a case in which a Nevada woman was jailed after a miscarriage. Lauren Weber of The Washington Post, Shefali Luthra of The 19th, and Jessie Hellmann of CQ Roll Call join 吃瓜不打烊鈥 Emmarie Huetteman to discuss these stories and more. Also this week, 吃瓜不打烊鈥 Julie Rovner interviews Irving Washington, a senior vice president at KFF and the executive director of its Health Misinformation and Trust Initiative.
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Vance Wrongly Blames Rural Hospital Closures on Immigrants in the Country Illegally
Experts disputed the claim by Republican vice presidential candidate JD Vance, noting that a range of other issues 鈥 from low reimbursement rates to declining patient use 鈥 combine to cause these facilities to shutter.
Less Than Two Weeks To Go
Episode 369With Election Day rapidly approaching, abortion is gaining traction as a voting issue, according to public opinion polls. Meanwhile, states with abortion bans are reviving the lawsuit 鈥 dismissed by the Supreme Court on a technicality this year 鈥 that could roll back the availability of the abortion pill mifepristone. Sarah Karlin-Smith of the Pink Sheet, Rachel Cohrs Zhang of Stat, and Victoria Knight of Axios join 吃瓜不打烊鈥 Julie Rovner to discuss these stories and more. Also this week, Rovner interviews Tricia Neuman, senior vice president of KFF and executive director of its Program on Medicare Policy, about Medicare open enrollment and the changes to the federal program for 2025.
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Medicare Drug Plans Are Getting Better Next Year. Some Will Also Cost More.
Every year, Medicare officials encourage beneficiaries to shop around for their drug coverage. Few take the time. This year, it might be more important than ever.
By Susan Jaffe -
Patients Are Relying on Lyft, Uber To Travel Far Distances to Medical Care
Uber and Lyft have become a critical part of the nation鈥檚 infrastructure for transporting ailing people from their homes 鈥 even in rural areas 鈥 to medical care sites in major cities such as Atlanta.
Yet Another Promise for Long-Term Care Coverage
Episode 367As part of her presidential campaign, Vice President Kamala Harris has rolled out a plan for Medicare to provide in-home long-term care services. The proposal would fill a longtime need for families trying to simultaneously care for young children and older parents, but its enormous price tag makes it a promise unlikely to be fulfilled. Meanwhile, a growing number of Republican candidates up and down the ballot facing voter backlash over their support for abortion restrictions are trying to reinvent their positions. Shefali Luthra of The 19th, Jessie Hellmann of CQ Roll Call, and Joanne Kenen of Johns Hopkins University and Politico join 吃瓜不打烊鈥 Julie Rovner to discuss these stories and more. Also this week, excerpts from a KFF lunch with 鈥淪hark Tank鈥 panelist and generic drug discounter Mark Cuban, who has been consulting with the Harris campaign about health care issues.
The Health of the Campaign
Episode 366The 2024 presidential race is taking on a familiar tone 鈥 with Democrats accusing Republicans of wanting to ban abortion and repeal the Affordable Care Act and Republicans insisting they have no such plans. Voters will determine whom they believe. Meanwhile, for the second time in a month, a state judge overturned an abortion ban, but few expect the decision to settle the matter. Alice Miranda Ollstein of Politico, Sandhya Raman of CQ Roll Call, and Anna Edney of Bloomberg News join 吃瓜不打烊 chief Washington correspondent Julie Rovner to discuss these stories and more. Also this week, Rovner interviews 吃瓜不打烊鈥 Lauren Sausser, who reported and wrote the latest 吃瓜不打烊-Washington Post 鈥淏ill of the Month,鈥 about a teenage athlete whose needed surgery lacked a billing code.