Medicare

Medicare is going to test new ways to reimburse doctors for medications, in hopes they'll choose less expensive drugs.

The plan would alter Medicare Part B, which pays for medicines administered in doctors offices or outpatient hospital clinics — to eliminate incentives for doctors to use the most expensive drugs.

Insurance giant Humana Inc., which operates some of the nation's largest private Medicare health plans, knew for years of billing fraud at some South Florida clinics but did little to curb the practice even though it could harm patients, a doctor alleges in a newly unsealed whistleblower lawsuit.

Dueling Star Ratings May Confuse Some Home Health Patients

Feb 23, 2016

Patients looking for home health care services will be impressed if they check out the federal government’s ratings of Brookdale Senior Living. Four of the company’s home health agencies — in Florida, North Carolina, Ohio and Rhode Island — each earned five stars, the top quality score, primarily based on Medicare’s assessment of how often patients got better.

Senators Reject Major Health Regulation Change

Feb 18, 2016

With hospitals, nursing homes and hospice providers lined up in opposition, a Senate panel Wednesday rejected a proposed overhaul of a key regulatory process for new health-care facilities.

Delay Of New Health Law Forms May Confuse Some Taxpayers

Feb 16, 2016

As the 2015 tax filing season gets underway, tax preparers said a delay in new health law tax forms is causing confusion for some consumers, while others want details about exemptions from increasingly stiff penalties for not having insurance.

Health insurer UnitedHealthcare will partner with a local doctor’s group in a move they say will lower health care costs.

Florida Attorney General Pam Bondi says she was wrong to urge the U.S. Centers for Medicare & Medicaid Services to pay for high-priced and unnecessary drug screening tests from a company being investigated for defrauding Florida Medicaid of millions.

Evan Lewis / Associated Press

Whether it’s coverage for end-of-life counseling or an experimental payment scheme for common surgeries, Medicare in 2016 is undergoing some of the biggest changes in its 50 years.

Medicare officials say researchers and the public will now have an easier way to analyze spending on costly prescription drugs.

Seven hospitals in Florida have agreed to pay the federal government about $9 million to settle allegations they submitted false claims to Medicare for a minimally-invasive procedure commonly used to treat spinal fractures from osteoporosis, a news release from the U.S. Department of Justice says.

A Fort Myers-based integrated cancer care services provider accused of billing for tests that were not needed will pay nearly $20 million to the federal government to settle allegations from a whistleblower that it violated the False Claims Act, according to a news release from the U.S. Department of Justice.

Medicare Penalizes 29 Florida Hospitals For Safety Incidents

Dec 15, 2015

The federal government is penalizing 758 hospitals with higher rates of patient safety incidents, and more than half of those places had also been fined last year, Medicare records released late Wednesday show.

A national healthcare company showed off its first Florida clinic today and it’s right here in Jacksonville. 

Alignment Healthcare is partnering with St. Vincent’s HealthCare and Florida Blue to provide comprehensive care to Medicare patients in Clay and Duval Counties.

Alignment Healthcare’s Chief Medical Officer Doctor Henry Do says one way they do that is with what’s called population care.

In recent months, hospital systems in Florida have paid out hundreds of millions of dollars to settle allegations of illegally compensating physicians. According to Modern Healthcare, those huge settlements are catching the attention of other potential whistleblowers.

End Of Medicare Bonuses Will Cut Pay To Primary Care Doctors

Nov 30, 2015

Many primary care practitioners will be a little poorer next year because of the expiration of a health law program that has been paying them a 10 percent bonus for caring for Medicare patients.

Associated Press

With time running out on open enrollment season, many seniors are facing sharply higher premiums for Medicare's popular prescription drug program. The reason: rising drug costs have overtaken a long stretch of stable premiums.

With time running out on open enrollment season, many seniors are facing sharply higher premiums for Medicare's popular prescription drug program. The reason: rising drug costs have overtaken a long stretch of stable premiums.

U.S. Army

Striving for better quality and more predictable costs, Medicare on Monday launched a major payment change for hip and knee replacements, the most common inpatient surgery for its 55 million beneficiaries.

.S. Department of Health and Human Services

One month into Medicare's enrollment period for seniors, the federal government announced that Medicare Part B premiums will be going up in 2016 for new enrollees.

Not every American 65 and older is worrying about Medicare's open enrollment period, now underway. Some who are eligible for the government insurance plan are staying on the job, and gaining access to employer-based plans they say are a better option. 

WellCare Sees Increase In Earnings

Nov 5, 2015
WellCare

Tampa-based WellCare Health Plans, which manages care for about 800,000 people in Florida's Medicaid program, saw an increase in earnings during the third quarter of the year, according to a filing Wednesday with the federal Securities and Exchange Commission.

Medicare said last week it will pay doctors to help patients plan what kind of care they want at the end of life, an idea more broadly accepted than six years ago, when it touched off a political uproar about “death panels.”

The Justice Department said Friday that it had reached settlements totaling more than $250 million with hundreds of hospitals where doctors implanted cardiac devices in violation of Medicare coverage requirements.

Daylina Miller/Health News Florida

Seniors enrolling in Medicare are facing a tough decision when it comes to which plans they should sign up for.

Anthem reported a 4 percent increase in third-quarter profit and beat Wall Street forecasts as the number of people the health insurer covers edged slightly higher.

Senior citizens are switching from privately run insurance plans to traditional Medicare when they face serious, long-term health conditions, a study shows.

Researchers at Brown University found that 17 percent of Medicare Advantage patients who entered nursing homes for long-term care chose to switch to traditional Medicare the following year. Only 3 percent of similar patients in Medicare made the decision to go to a private Medicare Advantage plan.

Insurers Find Out-Of-Network Bills As Much As 1,400 Percent Higher

Oct 5, 2015

It’s common knowledge that consumers have to pay more money if they choose doctors or hospitals outside of their insurance plan’s network. But a new analysis prepared by the insurance industry seeks to show just how much more in each of the 50 states.

Adventist Health System will pay $115 million to the U.S. Department of Justice to settle claims it offered doctors perks for patient referrals, the Daytona Beach News-Journal reports.

Medicare Yet To Save Money Through Heralded Medical Payment Model

Sep 14, 2015

A high-profile Medicare experiment pushing doctors and hospitals to join together to operate more efficiently has yet to save the government money, with nearly half of the groups costing more than the government estimated their patients would normally cost, federal records show.

A new model of health care run by doctors and hospitals is growing and saving money in the taxpayer-funded Medicare program, according to a new report from the federal government. However, experts say most patients still don’t understand how an Accountable Care Organization works.

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