KHN Morning Briefing

Summaries of health policy coverage from major news organizations

When Cut From Medicare Advantage Plans, Doctors Face Dilemma About Patients

In the meantime, Medicare is trying to crack down on habitual overcharging by some doctors.

The Washington Post: Doctors Cut From Medicare Advantage Networks Struggle With What To Tell Patients
Thousands of primary-care doctors and specialists across the country have been terminated from privately run Medicare Advantage plans, sparking a battle between doctors who say patient care is being threatened and insurers that insist they have to reduce costs and streamline their operations. Medical associations, which describe the dismissals as the largest in the program’s history, say the cuts are forcing some patients to leave their doctors in mid-treatment  (Cha, 1/25).

Earlier, related KHN story: Judge's Medicare Advantage Order Could Have National Impact (Jaffe, 12/6/13). 

The New York Times: Doctors Abusing Medicare Face Fines And Expulsion
The Obama administration is cracking down on doctors who repeatedly overcharge Medicare patients, and for the first time in more than 30 years the government may disclose how much is paid to individual doctors treating Medicare patients. Marilyn B. Tavenner, the administrator of the Centers for Medicare and Medicaid Services, said that “recalcitrant providers” would face civil fines and could be expelled from Medicare and other federal health programs. In a directive that took effect on Jan. 15 but received little attention, Ms. Tavenner indicated that the agency was losing patience with habitual offenders. She ordered new steps to identify and punish such doctors (Pear, 1/26).

And, for patients:

The Wall Street Journal: The Pitfalls Of Applying For Medicare 
Roughly 3.65 million Americans will turn 65 this year and become eligible for Medicare. But be warned: There's nothing simple about signing up for the government's health-care insurance program. "Medicare is complicated," says Paula Muschler, operations manager of the Allsup Medicare Advisor, a Medicare advisory-services company. "There is a lot seniors can do either right or wrong that can have a lasting impact on their health-care costs for the rest of their lives." ... Get a Medicare adviser, who, like a lawyer or a financial planner, can put you on the right track to finding the package that works best for your health and your pocketbook (Waters, 1/26).

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