Medicare

News and updates about Medicare.

A heavy workload caused by the Affordable Care Act, government technology limits and staff shortages are causing unusually long delays in filling public records requests, federal health officials say.

The waits in some cases could stretch out a decade or more.

The Freedom of Information Act requires federal agencies to respond to records requests in 20 working days, though providing documents often takes much longer. The FBI, for instance, recently reported that complex requests could average more than two years to fill.

Federal health officials were advised in 2009 that a formula used to pay private Medicare plans triggered widespread billing errors and overcharges that have since wasted billions of tax dollars, newly released government records show.

Kaiser Health News columnist Michelle Andrews answers questions from the public about the changing landscape of health insurance. 

Some readers want to figure out how to become eligible for coverage on the health insurance marketplaces, while others want to figure out how to avoid it. This week I answered questions from both.

In Medical Park Hospital in Winston-Salem, N.C., Angela Koons is still a little loopy and uncomfortable after wrist surgery. Nurse Suzanne Cammer gently jokes with her. When Koons says she's itchy under her cast, Cammer warns, "Do not stick anything down there to scratch it!" Koons smiles and says, "I know."

Koons tells me Cammer's kind attention and enthusiasm for nursing has helped make the hospital stay more comfortable.

More than 400,000 Medicare beneficiaries who may have been confused or misinformed about the pharmacy details of their 2015 Aetna prescription drug plans have until the end of this month to find participating pharmacies or switch plans, according to the Centers for Medicare & Medicaid Services.

Medical homes are a simple, compelling idea: Give primary-care doctors resources to reduce preventable medical crises for diabetics, asthmatics and others with chronic illness, and it will reduce hospital visits, improve lives and save money.

But it's not so easy in practice.

What Medicare gives with one hand, it's taking away with another. Most government quality bonuses to hospitals this year are being wiped out by penalties issued for other shortcomings.

The government is taking performance into account when paying hospitals, one of the biggest changes in Medicare's 50-year-history and one that's required by the Affordable Care Act.

In Oregon, Medicaid Now Covers Transgender Medical Care

Jan 10, 2015

Oregon began covering the cost of reassignment surgery for transgender people on Medicaid in January. It also covers things like hormone therapy and puberty suppression.

By doing so, Oregon joins a handful of other states that have recently taken steps to help people with gender dysphoria, or the conflict between the gender people identify with and their physical gender.

Some question the validity of coverage, but people in the transgender community are thrilled.

Are Doctors Driving Up Medical Costs?

Jan 9, 2015
The B's/Flickr

Last month, a study of Medicare data published in the journal JAMA Internal Medicine came out with a startling finding: The doctors earning the most from Medicare Part B dollars aren't the ones who treat the most patients. They're the ones who order the most tests.

Despite a national crackdown on prescription drug abuse, doctors churned out an ever-larger number of prescriptions for the most-potent controlled substances to Medicare patients, new data show.

In addition, ProPublica found, the most prolific prescribers of such drugs as oxycodone, fentanyl, morphine and Ritalin often have worrisome records.

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