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Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are stuck in the middle, but there’s a way out.
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As enrollment in Medicare Advantage plans grows, so do concerns about how well the insurance works, including from those who say they have become trapped in the private plans as their health declines.
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Some hospitals and physician groups are rejecting Medicare Advantage plans over payment rates and coverage restrictions, causing turmoil for patients.
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Positive Healthcare is a Medicare Advantage plan and includes prescription drug coverage for people with HIV or AIDS. Also known as PHP, it has offered coverage in Broward, Miami-Dade and Duval.
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Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and predicts what kind of care an individual will need. New rules will ensure humans are part of the process.
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Despite the prevalence of these cancers, many people aren’t aware of the warning signs. Also, a closer look at Medicare Advantage plans.
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Kaiser Health News has released never-before-seen details of federal audits as the government weighs action against dozens of Medicare Advantage plans.
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The rule would ban ads that market plans with confusing words, imagery or logos. The regulation would also prohibit ads that don’t specifically mention a health insurance plan by name.
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A KHN investigation found when some Medicare Advantage plans got a rare federal audit, they couldn't produce billing records for care they said they'd provided. Some blamed fire, flood — or doctors.
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Taxpayers footed the bill for care that should have cost far less, according to records released under the Freedom of Information Act. The U.S. government may charge insurers $650 million as a result.