KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Special Enrollment Periods Could Help Medicare Advantage Members With Dropped Doctors

In the meantime, for-profit hospices are scrutinized for how they bill Medicare.

St. Louis Post-Dispatch:  Experts Provide Options, Hope For UnitedHealthcare Medicare Patients 
For more than 40 years, Mary Anne Catalano and her family have gone to Dermatological Care Inc., a practice in St. Louis County. ... Now, at 68 and in the middle of her contract term, UnitedHealthcare is kicking the entire Dermatological Care staff out of her Medicare Advantage network. ... At the beginning of June, UnitedHealthcare notified almost 10 percent of Missouri physicians in its Advantage network that they will be terminated -- almost 1,000 doctors. The insurer gave no clear reason for the cuts, and patients may feel forced to switch doctors in the middle of their policy term or pay high out-of-pocket costs. But some experts say there are other options, and maybe even some hope. At the patient level, Medicare provides 17 special enrollment periods that allow consumers to switch coverage and find a plan that carries their doctors (Kulash, 6/28).

WBUR: Weekend Listening: For-Profit Hospice Care As Big Business
The for-profit hospice care is a growth industry in this country. But taxpayer beware. (And it is the taxpayer who is footing the bill, big-time.) … Too many of these for-profit hospices are gaming U.S. law and cherry-picking patients, finding ways to reap big profits from the Medicare system, taking people who will take longer to die -- and sending them home if they take too long to die, so they can maximize profits. And some of them -- including big, national corporations -- have been sued repeatedly by the federal government for their practices. Patient for patient, the for-profits cost the U.S. Treasury a lot more money (Kotsonis, 6/27).

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