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Federal officials are allowing the private insurance plans to use “step therapy” for drugs administered by doctors. In step therapy, patients must first use cheaper drugs to see if they work before receiving more expensive options.
In this episode of KHN’s “What the Health?” Julie Rovner of Kaiser Health News, Anna Edney of Bloomberg News, Margot Sanger-Katz of The New York Times and Kimberly Leonard of the Washington Examiner talk about the latest Trump administration efforts to address high drug prices, what’s next for short-term health insurance plans and insider trading charges against a New York GOP congressman.
Federal law bars insurers from using these test results for health coverage, but they can influence whether you get a plan covering long-term care.
Seniors often don’t realize that private insurers are required to offer Medigap policies, or supplemental insurance, only when people first sign up for Medicare.
On April 1, Medicare launched a major initiative — a diabetes prevention program for seniors and people with serious disabilities— that is available in only a few cities.
Under new federal rules unveiled this week, these privately run alternatives to traditional Medicare might provide air conditioners, rides to medical appointments and home-delivered meals.
Last month’s budget deal means Medicare beneficiaries are eligible for physical and occupational therapy indefinitely. Plus, prescription drug costs will fall for more seniors.
Despite Medicare Advantage plans’ increasing popularity, several key features remain poorly understood. Here is what you need to know.
Most beneficiaries have from Oct. 15 to Dec. 7 to decide on drug coverage and whether to switch from traditional Medicare to a Medicare Advantage plan.
To strengthen your core knowledge of health care policy, it helps to be a regular reader of Kaiser Health News. Here’s a pop quiz to gauge what you have learned.
A Wisconsin lawsuit alleges United Healthcare downplayed abusive sales tactics to avoid losing government bonuses.
At a hearing Wednesday, federal health officials pointed to billing errors, fraud and overcharges that led Medicare to overpay by staggering sums.
Although proponents say the policies offered by nursing homes are more attuned to patients, some report frustrations when trying to dispute care decisions.
Medicare Advantage plans offer good value and aim to keep patients healthy but sicker people are far more likely to quit because they can’t get the care they need.
Freedom Health and Optimum HealthCare agreed to settle a lawsuit alleging they overbilled Medicare.
The company, which is the nation’s largest Medicare Advantage operator, denies wrongdoing and argues that the Justice Department “fundamentally misunderstands” how Medicare Advantage works.
The powerful chairman of the Senate Judiciary Committee wants the Centers for Medicare and Medicaid Services to explain $125 million in overcharges by insurers.
The Department of Justice is joining a whistleblower lawsuit in a fraud case against UnitedHealth in which damages could top $1 billion.
The effect of “repeal and replace” could have greatest consequences for hospitals. They accepted lower federal funding under the law because their uncompensated care was expected to fall as more people became insured.
Federal officials have released final regulations for the new program, which will reward physicians for providing high quality, efficient care.