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The United States has the most dysfunctional, inefficient, bureaucratic and expensive health care system in the world. That’s not just what I believe. That’s what the American people know to be true. According to a March 2022 survey by Gallup and West Health, an estimated 93 percent of American adults feel what they pay for health care is not worth the cost. That poll also showed that 64 percent of Americans are dissatisfied with the availability of affordable health care. Today, according to the Center for Medicare and Medicaid Services (CMS), we now spend an unbelievable $12,530 per person for...

While there are many government aid programs available for people experiencing poverty, filling out the paperwork is usually the hardest part. In 1995, Congress passed a bill called the Paperwork Reduction Act to reduce the amount of government forms that need to be filled out by people and nonprofit organizations, especially if they are filling out forms for multiple kinds of government agencies. Nearly three decades later, many people still find the process of applying for government aid daunting. Insider spoke with four mothers who receive different forms of government aid to see what it's really like.

Coverage for eligible, necessary care is denied each year to tens of thousands of seniors with private Medicare Advantage plans, U.S. federal investigators say. In a report released Thursday, the team from the inspector general's office of the U.S. Department of Health and Human Services said Medicare needs to improve oversight of these plans and strengthen enforcement against those private insurance companies with a pattern of improper denials of coverage. About 28 million older people have Medicare Advantage plans, which offer privatized versions of Medicare that are often cheaper and provide a greater range of benefits than the traditional government...

A California doctor was sentenced today to 93 months in prison for defrauding Medicare, re-packaging single-use catheters for re-use on patients, and submitting false declarations in a bankruptcy proceeding. According to court documents, Donald Woo Lee, 55, of Temecula, recruited Medicare beneficiaries to his clinics, falsely diagnosed the beneficiaries, and provided the beneficiaries with medically unnecessary procedures. Lee billed these unnecessary procedures to Medicare using an inappropriate code in order to obtain a higher reimbursement, a practice known as “upcoding.” In addition, the evidence showed that Lee re-packaged used, contaminated catheters for re-use on patients. These catheters had been cleared...

Paul Ryan has one big complaint about former President Donald Trump: He wasn't willing to pursue cuts to the safety net programs Ryan had championed for years. "He and I fought about Medicare and entitlement reform all the time," the former GOP House speaker said Wednesday at a book event at the American Enterprise Institute, a conservative think tank. "It became clear to me there was no way he wanted to embrace that."

Sen. Mitt Romney of Utah suggested that he'd favor cutting retirement benefits for younger Americans in a bid to stabilize safety net programs. "If we're ever going to get a handle on our debt, we're gonna have to find a way to either increase revenue, which I don't favor, or find a way to adjust our long-term benefits not for current retirees," he said at a Senate Budget Committee hearing on Wednesday, seemingly ruling out any tax hikes. "But for younger people coming along, we got to be able to find a way to balance these programs or we're gonna...

Investors who take an interest in Clover Health Investments, Corp. (NASDAQ:CLOV) should definitely note that the Independent Director, Chelsea Clinton, recently paid US$2.53 per share to buy US$253k worth of the stock. However, it only increased shareholding by a small percentage, and it wasn't a huge purchase by absolute value, either. View our latest analysis for Clover Health Investments Clover Health Investments Insider Transactions Over The Last Year The insider Chamath Palihapitiya made the biggest insider purchase in the last 12 months. That single transaction was for US$10.0m worth of shares at a price of US$5.75 each. So it's clear...

For years, the warnings about Medicare's inadequate funding and rising costs have been dire. Congress knows it needs to do something, but politics and the complexity of the task keep even partial fixes in stalemate. "The financial health of Medicare is terrible," says Robert Moffit, a senior fellow in domestic policy studies specializing in health care and entitlement programs at the Heritage Foundation , a conservative think tank. Medicare costs almost a trillion dollars each year, he says. "The trustees have been warning Congress and the president that it's a problem that can't be ignored." By 2026, Medicare's trust fund...

WASHINGTON (AP) — The Biden administration, seeking to fill a frustrating gap in coverage for COVID-19 tests, Thursday announced that people with Medicare will be able to get free over-the-counter tests much more easily in the coming weeks. The Centers for Medicare & Medicaid Services said Medicare will cover up to eight free tests per month, starting in early spring. The tests will be handed out at participating pharmacies and other locations. They’ll be available to people who have Medicare’s “Part B” outpatient benefit, which about 9 in 10 enrollees sign up for. Last month, the administration directed private insurers...

The Biden administration is exploring ways for Medicare beneficiaries to get over-the-counter, at-home COVID-19 tests for free. The White House is requiring private insurance companies to cover the cost of eight at-home COVID-19 tests per person each month, if the customer files for reimbursement. The requirement was put in place as a result of the massive surge in infections due to the omicron variant.

Denying natural immunity in the Centers for Medicare & Medicaid Service (CMS) vaccine mandates is “unprecedented in modern history,” a prominent public health expert said. Dr. Scott Atlas, a former White House COVID-19 Task Force adviser during the Trump administration, made the remarks after the U.S. Supreme Court (SCOTUS) decide to uphold the CMS vaccine mandates in a Thursday ruling. He told The Epoch Times that the ruling is “another serious denial of scientific fact” specifically mentioning the denial of natural immunity in CMS vaccine mandates.

— Proposal would cover aducanumab (Aduhelm) in patients on qualifying clinical trialsMonoclonal antibodies targeting amyloid beta in Alzheimer's disease, including the newly approved drug aducanumab (Aduhelm), would be covered for people with Medicare only if they are enrolled in qualifying clinical trials, according to CMS plans announced Tuesday. The proposed CMS National Coverage Determination would cover FDA-approved monoclonal antibodies targeting amyloid in Alzheimer's disease through coverage with evidence development (CED). To date, the only such approved treatment is aducanumab. "Throughout this National Coverage Determination process, CMS has been and remains committed to providing the American public with a clear, trusted,...

The Centers for Medicare & Medicaid Services (CMS), in a policy reversal, announced on Dec. 28 that it would start enforcing its COVID-19 vaccine mandate to facilities in half the U.S. states, where the mandate hasn’t been judicially enjoined.CMS modified the compliance dates for the vaccine mandates. Facilities that receive Medicaid or Medicare funding must comply with the mandate’s first phase, meaning that all health care staff has to have received the first dose of the Pfizer or Moderna vaccine, or the single-shot Johnson & Johnson vaccine by Jan. 27, 2022—or 30 days after the CMS memorandum (pdf) was issued.Those...

The Biden administration will offer bonuses to doctors who "create and implement an anti-racism plan" under new rules from the Department of Health and Human Services, a move meant to update Medicare payments to "reflect changes in medical practice." Effective Jan. 1, Medicare doctors can boost their reimbursement rates by conducting "a clinic-wide review" of their practice's "commitment to anti-racism." The plan should cover "value statements" and "clinical practice guidelines," according to HHS, and define race as "a political and social construct, not a physiological one"—a dichotomy many doctors say will discourage genetic testing and worsen racial health disparities.

WASHINGTON (AP) — The head of a Senate panel that oversees Medicare says the Biden administration should use its legal authority to cut back a hefty premium increase soon hitting millions of enrollees, as a growing number of Democratic lawmakers call for action amid worries over rising inflation. Last month, Medicare announced one of the largest increases ever in its “Part B” monthly premium for outpatient care, nearly $22, from $148.50 currently to $170.10 starting in January. The agency attributed roughly half the hike, about $11 a month, to the need for a contingency fund to cover Aduhelm, a new...

A bill introduced on Tuesday would allow for another increase in the debt limit, and forestall expected Medicare reductions that are a sole result of Democrats’ agenda.Just when Democrats and their agenda continue to flounder, along comes Mitch McConnell to give them another lifeline. Rather than using the mismanagement of the Senate by Majority Leader Chuck Schumer to extract concessions, McConnell gave two huge concessions to bail Schumer out of his self-inflicted wounds. A bill introduced on Tuesday would allow for another increase in the debt limit, and forestall expected Medicare reductions that are a sole result of Democrats’ disastrous...

The federal Centers for Medicare and Medicaid Services (CMS) suspended enforcement of its vaccine mandate for healthcare workers after two court orders earlier this week.A memo issued by the agency, posted by Missouri Attorney General Eric Schmitt on Twitter Thursday, said that CMS “remains confident” it will prevail in court but is “suspending activities related to the implementation and enforcement of this rule pending future development in the litigation.”“While these preliminary injunctions are in effect,” it continues to say, “CMS surveyors must not survey providers for compliance with the requirements” with the rule. The memo is referring to federal government...

Judge Matthew Schelp of the Eastern District of Missouri issued an injunction halting President Joe Biden's Wuhan coronavirus vaccine mandate for Medicare and Medicaid workers in ten states Monday, citing a lack of approval from Congress. "The mandate requires nearly every employee, volunteer, and third-party contractor working at fifteen catogires of healthcare facilities to be vaccinated against SARS-CoV-2 (“COVID”) and to have received at least a first dose of the vaccine prior to December 6, 2021," court documents show. "Congress did not grant CMS authority to mandate the vaccine. Plaintiffs are likely to succeed in their argument that Congress has...

The latest version of Democrats’ $4 trillion Build Back Better reconciliation bill includes a provision to empower the government to set Medicare drug prices.Government price-setting of prescription drugs is zombie legislation that just won’t die. After briefly being excised due to opposition from moderate legislators, the latest version of congressional Democrats’ $4 trillion Build Back Better reconciliation bill includes a provision to allow the government to set Medicare drug prices. “Democrats announced they have sealed a deal [on] pharmaceutical drug costs for seniors,” announced the Associated Press last week. The consequences of prescription drug price-setting in terms of reduced access...

At some point in the near future—whether a few days or a few weeks—the Congressional Budget Office (CBO) will release a complete score of the spending spree legislation Speaker Nancy Pelosi, D-California, and House leaders introduced on Nov. 3. The document will represent the first complete CBO analysis of any of the multi-trillion-dollar spending bills that Democrats have spent the fall writing, then re-writing. Two budgetary analyses suggest CBO could find the most recent version of the legislation increases the deficit. A Penn-Wharton analysis of the White House’s policy framework concluded it would spend $1.87 trillion over ten years while...