Medicare

As he takes the reins of the Senate Health, Education, Labor & Pensions Committee, the independent from Vermont maps out his strategy for negotiating with Republicans — and Big Pharma.

In a surprise decision, U.S. officials yield to insurance industry demands — at least for now.

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

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.

New reductions in payments in 2023 will drive more doctors away from accepting Medicare patients, physicians say. They are again pushing back on efforts largely designed to control government spending.

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.

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.