Connect with us

Kaiser Health News

Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits

Published

on

kffhealthnews.org – Fred Schulte, KFF Health News – 2024-11-08 04:00:00

SUMMARY: A new federal audit from the Health and Human Services Inspector General highlights concerns over $7.5 billion in Medicare Advantage overpayments linked to home visits that yielded no medical treatment in 2023. Despite these findings, the Centers for Medicare & Medicaid Services (CMS) declined to limit payments for such visits, arguing they enhance in-home care access. The audit suggests UnitedHealthcare accounted for a significant portion of contested payments, highlighting inefficacies in treating diagnosed conditions. Critics argue CMS needs stronger oversight to prevent potential waste of taxpayer dollars and enforce accurate diagnosis reporting.

Read the full article

The post Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits appeared first on kffhealthnews.org

Kaiser Health News

LGBTQ+ People Relive Old Traumas as They Age on Their Own

Published

on

kffhealthnews.org – Judith Graham – 2024-12-24 07:00:00

SUMMARY: Bill Hall, a 71-year-old HIV survivor, has endured numerous health challenges, including depression, heart disease, and cancer since contracting the virus in 1986. His struggles are compounded by trauma from childhood, where he faced bullying and abuse in a government boarding school. LGBTQ+ seniors like Hall often face isolation, with many living alone and lacking social support. By 2030, the number of LGBTQ+ seniors is projected to double, increasing their vulnerability to health issues and mental struggles. Many have experienced profound loss from the AIDS crisis, leading to ongoing emotional challenges. Support services remain critical for this aging population.

Read the full article

The post LGBTQ+ People Relive Old Traumas as They Age on Their Own appeared first on kffhealthnews.org

Continue Reading

Kaiser Health News

Caseworkers Coax Homeless People out of Las Vegas’ Tunnels for Treatment

Published

on

kffhealthnews.org – Angela Hart – 2024-12-23 07:00:00

SUMMARY: In Las Vegas, case manager Bryon Johnson searches the underground tunnels for homeless individuals like Jay Flanders, who suffers from health issues and substance abuse. Escaping rising housing costs and law enforcement, around 1,200 to 1,500 people live in these tunnels, which provide shelter from extreme weather but pose significant health risks, especially during monsoon season. Outreach workers emphasize the dangers of drug addiction and untreated health conditions, urging residents to seek medical care above ground. As housing costs soar, many homeless individuals, including tourists, end up in these perilous conditions, seeking cover from societal judgment and harsh weather.

Read the full article

The post Caseworkers Coax Homeless People out of Las Vegas’ Tunnels for Treatment appeared first on kffhealthnews.org

Continue Reading

Kaiser Health News

In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M

Published

on

kffhealthnews.org – Fred Schulte, KFF Health News – 2024-12-20 16:31:00

SUMMARY: Independent Health Association of Buffalo and Betsy Gaffney, CEO of medical analytics firm DxID, have agreed to a settlement of up to $100 million to resolve Justice Department allegations of fraudulent Medicare billing for exaggerated or non-existent health conditions. Independent Health will pay up to $98 million, while Gaffney will contribute $2 million. Neither party admitted wrongdoing. The case was triggered by whistleblower Teresa Ross, highlighting issues of “upcoding” in Medicare Advantage plans. Ross, having faced repercussions for her allegations, will receive at least $8.2 million from the settlement. This case underscores the challenges of regulating billing practices in the Medicare system.

Read the full article

The post In Settling Fraud Case, New York Medicare Advantage Insurer, CEO Will Pay up to $100M appeared first on kffhealthnews.org

Continue Reading

Trending