Susan Jaffe - Kaiser Health News

The Biden administration is considering whether Medicaid, which pays the bills for 62% of nursing home residents, should require that most of that funding be used to provide care, rather than for maintenance, capital improvements, or profits.

Private and public employers are increasingly using the government’s Medicare Advantage program as an alternative to their existing retiree health plan and traditional Medicare coverage. As a result, the federal government is paying the “overwhelming majority” of medical costs, according to an industry analyst.

If federal officials accept a court’s decision, some patients will get a chance to seek refunds for their nursing home and other expenses.

Officials have threatened to penalize the private companies selling Medicare Advantage and drug plans if they or agents working on their behalf mislead consumers.

With a deadline for Medicare enrollment looming, some lawmakers and advocates are concerned that Medicare hasn't done enough to reach out to consumers who might be affected by website problems.

A billing glitch could cause lapses in private drug policies and Medicare Advantage plans that provide both medical and drug coverage. Premiums weren't deducted from some Social Security checks.

To help seniors stay healthy and independent, some Medicare plans will soon cover things like home-delivered meals or rides to the doctor, but finding plans that include the coverage is not easy.

Federal officials will allow private Medicare insurance plans to require patients who are candidates for certain expensive drugs to try cheaper drugs first.

Sometimes a drug plan's copay is higher than the cash price, but insurance rules keep pharmacists from telling Medicare beneficiaries unless they ask.

Last month's congressional budget deal included some benefits for Medicare recipients that may reduce their drug expenses and increase the coverage for certain therapies.