Latest 蘑菇影院 Health News Stories
Journalists Demystify Bird Flu, Brain Worms, and New Staffing Mandates for Nursing Homes
蘑菇影院 Health News and California Healthline staff made the rounds on national and local media in recent weeks to discuss topical stories. Here鈥檚 a collection of their appearances.
Medicare Stumbles Managing a Costly Problem 鈥 Chronic Illness
Nearly a decade ago, Medicare launched a program to help the two-thirds of beneficiaries with chronic conditions by paying their doctors an additional monthly fee to coordinate their care. The strategy has largely failed to live up to its potential; only about 4 percent of potentially eligible beneficiaries in the traditional Medicare program are enrolled, […]
Biden Administration Sets Higher Staffing Mandates. Most Nursing Homes Don鈥檛 Meet Them.
The staffing regulation was disparaged by the industry as unattainable. Patient advocates say it doesn鈥檛 go far enough. Labor unions welcomed the requirement.
Lawsuit Alleges Obamacare Plan-Switching Scheme Targeted Low-Income Consumers
The lawsuit filed in federal court alleges that large call centers were used to enroll people into Affordable Care Act plans or to switch their coverage, all without their permission.
When Rogue Brokers Switch People鈥檚 ACA Policies, Tax Surprises Can Follow
Some tax filers鈥 returns are being rejected because they failed to provide information about Affordable Care Act coverage they didn鈥檛 even know they had.
Unauthorized Sign-Ups Cast Shadow on Obamacare鈥檚 Record Enrollment
The Biden administration faces what looks like a growing problem for the federal Affordable Care Act鈥檚 insurance exchange: disreputable insurance brokers enrolling people who don鈥檛 need coverage or switching them to new plans without their authorization. It happened to Michael Debriae, a restaurant server who lives in Charlotte. Unbeknownst to him, an agent in Florida […]
Your Doctor or Your Insurer? Little-Known Rules May Ease the Choice in Medicare Advantage
Disputes between hospitals and Medicare Advantage plans are leading to entire hospital systems suddenly leaving insurance networks. Patients are left stuck in the middle, choosing between their doctors and their insurance plan. There鈥檚 a way out.
Biden Cracks Down on Prior Authorization 鈥 But There Are Limits
More than a year after it was initially proposed, the Biden administration announced a final rule yesterday that will change how insurers in federal programs such as Medicare Advantage use prior authorization 鈥 a long-standing system that prevents many patients from accessing doctor-recommended care. 鈥淲hen a doctor says a patient needs a procedure, it is […]
Will CMS Crack Down on Prior Authorization?
There鈥檚 the Idaho doctor whose infant daughter developed a brain tumor. A woman in Southern California who waited months for an MRI before dying in the hospital. And a North Carolina patient who has trigeminal neuralgia 鈥 a condition so painful it鈥檚 commonly called the 鈥渟uicide disease.鈥 They all have something in common, aside from […]
Readers Slam Hospital Monopolies and Blame the Feds for Understaffed Nursing Homes
蘑菇影院 Health News gives readers a chance to comment on a recent batch of stories.
Medicaid鈥檚 鈥楿nwinding鈥 Can Be Especially Perilous for Disabled People
Earlier this year, Beverly Likens thought she鈥檇 done everything she needed to do to keep her Medicaid. Then came an unwelcome surprise: Ahead of surgery to treat chronic bleeding, the hospital said her insurance was inactive, jeopardizing her procedure. Likens had just been diagnosed with severe anemia and given a blood transfusion at the emergency room. 鈥淚 […]
Lost in the Mix of Medicaid 鈥楿nwinding鈥: Kentucky Cut Off Her Health Care Over a Clerical Error
The state canceled Beverly Likens鈥 coverage 鈥 days before surgery 鈥 without considering other ways she qualified for Medicaid, which experts say violated federal regulations.
Nursing Homes Say They Can鈥檛 Afford Higher Staffing. But Their Finances Are Often Opaque.
Perhaps the biggest mystery, as the Biden administration moves to force nursing homes to boost staffing, is this: how much extra money do the nation鈥檚 15,000 homes actually have to hire and retain more nurses and aides? Public comments are due Monday on the most sweeping regulatory changes to hit the industry in decades. The […]
Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients
Software sifts through millions of medical records to match patients with similar diagnoses and characteristics and then predicts what kind of care an individual will need and for how long. New federal rules will ensure human experts are part of the process.
These Appalachia Hospitals Made Big Promises to Gain a Monopoly. They鈥檙e Failing to Deliver.
Ballad Health, the only hospital system across a large swath of Tennessee and Virginia, has fallen short of quality-of-care and charity care obligations 鈥 even as it鈥檚 sued thousands of patients for unpaid bills.
Biden Administration Proposes New Standards to Boost Nursing Home Staffing
The proposal would require major hiring at the most sparsely staffed homes. But the proposal is already badly received by the nursing home industry, which claims it can鈥檛 boost wages enough to attract workers.
Exclusive: CMS Study Sabotages Efforts to Bolster Nursing Home Staffing, Advocates Say
Research commissioned by the Centers for Medicare & Medicaid Services analyzed only staffing levels below what experts have previously called ideal. Patient advocates have been pushing for more staff to improve care.
After Backlash, Feds Cancel Plan That Risked Limiting Breast Reconstruction Options
The Centers for Medicare & Medicaid Services backed off from a plan that could have curtailed access to a type of reconstructive surgery known as DIEP flap. Breast cancer patient advocates are relieved.
Look Up Your Hospital: Is It Being Penalized by Medicare?
Each year, Medicare punishes hospitals that have high rates of readmissions and high rates of infections and patient injuries. Check out which hospitals have been penalized.
The Real Costs of the New Alzheimer鈥檚 Drug, Most of Which Will Fall to Taxpayers
The annual cost of lecanemab treatment quadruples if the expense of brain scans to monitor for bleeds and other associated care is factored in. The full financial toll likely puts it beyond reach for low-income seniors at risk of Alzheimer鈥檚, experts say.
