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The Latest Breaking News from CMS

How Medicare Advantage plans dodged auditors and overcharged taxpayers by millions

In April 2016, government auditors asked a Blue Cross Medicare Advantage health plan in Minnesota to turn over medical records of patients treated by a podiatry practice whose owner had been indicted for fraud.

Tribune News Service

Medicare Advantage health plans dodged auditors, overcharged taxpayers millions

A review of 90 government audits reveals the plans have repeatedly tried to get around mandates to document medical conditions the government paid them to treat.

Chicago Sun-Times

The Medicare Advantage plan scandal

Health insurers that issue Medicare Advantage plans have repeatedly tried to sidestep regulations, audits find

Salon

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How Medicare Advantage plans dodged auditors and overcharged taxpayers by millions

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.

WEKU

Pagan nurse files religious discrimination lawsuit

LAS VEGAS — A Las Vegas nurse and self-described pagan has sued the hospital that fired her after it rejected her request for a religious exemption to its COVID-19 vaccination requirement.

Tribune News Service

Older adults face Medicare hurdles for substance use treatment

For the staff at the Senior Recovery Center in Maplewood, Minnesota, helping older adults overcome substance use disorders is a calling, said Christine Martinek, a licensed alcohol and drug counselor there.

Tribune News Service

More panellists revealed for Insider's Business Breakfast

The event in January will feature a keynote speech, panel discussion and Q&A session

Insider UK

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New Alzheimer's drug faces uncertain regulatory path

The FDA will soon decide whether to approve Eisai's experimental drug lecanemab.

Axios

Older adults face Medicare hurdles for substance use treatment - Roll Call

Only 6 percent of Medicare beneficiaries 65 and up reporting alcohol or substance use disorder received treatment, according to research.

Roll Call

Republican attorneys general file petition to repeal vaccine mandate for healthcare workers

Twenty-two attorneys general filed a petition on November 17, 2022, requesting the Biden administration to repeal the vaccine mandate for healthcare workers. The Centers for Medicare and Medicaid Services (CMS) issued an interim final rule on November 5, 2021, requiring healthcare workers to receive the COVID-19 vaccine. The interim rule…

Ballotpedia

Audits — hidden until now — reveal millions in Medicare Advantage overcharges

Newly released federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage health plans for seniors, with some plans overbilling the government more than $1,000 per patient a year on average.

Tribune News Service

Path cleared for Georgia to launch work requirements for Medicaid

Georgia is set to become the only state to have work requirements for Medicaid coverage.

Tribune News Service

Hidden audits reveal millions in overcharges by Medicare Advantage plans

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.

WEKU

The Medicare insulin price cap explained

A cut in drug prices for some Medicare beneficiaries kicks in next year, but finding those savings isn't easy

Salon

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Tribune News Service

Medicare plan finder likely won’t note new $35 cap on out-of-pocket insulin costs

A big cut in prescription drug prices for some Medicare beneficiaries kicks in next year, but finding those savings isn’t easy.

Salon

Hospital probed after denying abortion

In the wake of Missouri's abortion ban, one hospital is in hot water after denying an essential abortion

Tribune News Service

Medicare phone scammers want to slash your benefits and leave you with fewer in-network providers

You answer the phone and you’re greeted by a weird tone, followed by a few seconds of silence.

The Independent UK

Medicare enrollees warned about deceptive marketing schemes

With Medicare’s open enrollment underway, health experts are warning older adults about an uptick in misleading marketing tactics that might lead some to sign up for Medicare Advantage plans that don’t cover their doctors or prescriptions and drive up their out-of-pocket costs

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Ballotpedia

Hall Pass: Your Ticket to Understanding School Board Politics, Edition #36

Welcome to Hall Pass, a newsletter written to keep you plugged into the conversations driving school board politics and governance.

Tribune News Service

Missouri hospital investigated for allegedly denying an emergency abortion

The federal government has launched its first confirmed investigation of an alleged denial of an abortion to a woman experiencing a medical emergency.

Birmingham Post

Angel investors follow venture capitalists with funding injection into Hull siblings' no-code app firm

February has also been placed on accelerator programme for IP-rich start-ups

Newsroom.co.nz

Inside DoC’s slow ride towards more biking

Almost two years after a review was flagged on conservation land, DoC is in “preparatory and planning” mode

Tribune News Service

As hepatitis C proliferates, states lift barriers to treatment

While national efforts to eliminate hepatitis C have faced setbacks because of increased drug use, the impact of COVID-19 and insurance complications, there’s a bright spot: Some states are now making it easier for patients to treat the disease.

Roll Call

As hepatitis C proliferates, states lift barriers to treatment - Roll Call

States that have traditionally imposed restrictions to costly hepatitis drugs are now lifting those barriers.

Tribune News Service

After Congress fails to add dental coverage, Medicare weighs limited benefit expansion

Proposed changes in Medicare rules could soon pave the way for a significant expansion in Medicare-covered dental services, while falling short of the comprehensive benefits that many Democratic lawmakers have advocated.

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