KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Decoding Part D Marketing And Other News

The Medicare NewsGroup examines the complexity of Part D plans.

The Medicare NewsGroup: Figuring Out The Part D Market
Choosing a Medicare Prescription Drug (Part D) plan is a tricky business. Most beneficiaries go for the cheapest monthly premium, but this can be a big mistake, especially for those with unusual or expensive medications. Over the years, the marketers of Part D plans have made them increasingly complex, adding tiers of varying prices and using "medication management" techniques, which can make patients and doctors jump through veritable hoops to get a prescription filled (Rosenblatt, 11/29).

Also in the news about Medicare, various stories about Medicare's vulnerability to fraud, and lawmakers' interest in finding new ways to fight the abuse.

The Washington Post: Audit Finds Billions In Unverified Medicare Spending
Medicare has paid doctors and hospitals billions of dollars to switch from paper to electronic health records without verifying that the new systems meet required quality standards, according to a federal audit released Thursday (Aizenman, 11/29).

Medpage Today: Medicare Fraud Efforts Queried
Lawmakers are exploring ways to fight Medicare fraud and abuse as part of the effort to trim the federal budget and they're looking to the private sector for suggestions. For instance, investigators at the health insurer WellPoint recently contracted with a company to mine data on practice patterns and spot spikes in payment or identify emerging areas of fraud potential, Alanna Lavelle, Wellpoint's director of special investigations, told members of the House Energy and Commerce Health Subcommittee on Wednesday. The most egregious billers are flagged and investigated for potential waste, fraud, and abuse, Lavelle said (Pittman, 11/29).

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