CMS

Kaiser Health News has released never-before-seen details of federal audits as the government weighs action against dozens of Medicare Advantage plans.

The Centers for Medicaid & Medicare Services gives facilities an overall star rating along with details on health care, staffing and quality at its Care Compare website.

The investigations into select nursing homes are aimed at verifying whether patients have been properly diagnosed with the psychiatric disorder.

The many options — particularly urgent care and free-standing ERs — can make the head spin. The wrong choice can mean big bills and even poor outcomes. Facilities have little incentive to clear up the confusion.

The legislation will sunset a requirement of the COVID public health emergency that the Biden administration has been under mounting pressure to end. States were prohibited from booting people off Medicaid with the emergency in effect.

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.

A months-long examination found gaping holes and expansive gray areas through which banned individuals slip to repeatedly bilk Medicaid, Medicare and other taxpayer-funded federal programs.

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.

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.

The popularity of at-home COVID tests has amplified calls from health researchers and diagnostic companies to make testing similarly routine for sexually transmitted diseases. But FDA guidelines are lagging.