CMS

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.

A court decision last year makes it easier for low-income residents in Florida and other states that haven’t expanded Medicaid to make good-faith estimates of a pay increase, and there is no financial penalty if they don’t hit that figure.

In August, Congress approved a $35 cap on what seniors will pay for insulin, but that change came too late to add to the online tool that helps Medicare beneficiaries compare drug and medical plans.

Federal officials said they are penalizing 2,273 hospitals, the fewest since the fiscal year that ended in September 2014. Driving the decline was a change in the formula to compensate for the chaos caused by the COVID-19 pandemic.