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Judge refuses to extend timeframe for Georgia's new Medicaid plan, only one with work requirement
Read full article: Judge refuses to extend timeframe for Georgia's new Medicaid plan, only one with work requirementA federal judge has ruled that the Biden administration complied with the law when it declined to grant an extension to Georgia’s year-old Medicaid plan, which is the only one in the country that has a work requirement for recipients of the publicly funded health coverage for low-income people.
Can a Medicaid plan that requires work succeed? First year of Georgia experiment is not promising
Read full article: Can a Medicaid plan that requires work succeed? First year of Georgia experiment is not promisingBy now, Georgia officials expected their new Medicaid plan to provide health insurance to 25,000 low income residents.
'Obamacare' enrollment rising as COVID-19 pandemic deepens
Read full article: 'Obamacare' enrollment rising as COVID-19 pandemic deepensGovernment figures out Friday, Dec. 18 show sign-ups for Obamacare health insurance plans are trending more than 6% higher amid surging coronavirus cases and deepening economic misery. Numbers from New Jersey and Pennsylvania were not counted in Friday's tally from HealthCare.gov states. President Donald Trump failed to repeal “Obamacare" his first year in office, an early defeat he never forgot. Nonetheless, the Trump administration ignored calls to provide a special sign-up period related to the pandemic, something President-elect Joe Biden has said he will do. “This is the largest increase in HealthCare.gov enrollment since 2016 and it's the only increase during the Trump administration,” said Joshua Peck, who once served as marketing chief for the program.
'Obamacare' sign-ups begin as millions more are uninsured
Read full article: 'Obamacare' sign-ups begin as millions more are uninsuredWASHINGTON – Millions of Americans who have lost health insurance in an economy shaken by the coronavirus can sign up for taxpayer-subsidized coverage starting Sunday. It's not a new COVID relief program from the government but the return of annual sign-up season under the Affordable Care Act, better known as “Obamacare.” Open enrollment runs through Dec. 15. "We’ll be working through the upcoming open enrollment period...to ensure a smooth user experience,” CMS Administrator Seema Verma said. Some private businesses, such as HealthSherpa.com, have created a niche market helping people enroll in HealthCare.gov plans. But, Dorn said, “a lot of people who need health insurance may not know there this is there chance to sign up."
Trump rule says health plans must disclose costs up front
Read full article: Trump rule says health plans must disclose costs up frontA related Trump administration price disclosure requirement applying to hospitals is facing a federal lawsuit from the industry, alleging coercion and interference with business practices. The idea behind the new regulations on insurers is to empower patients to become better consumers of health care, thereby helping to drive down costs. “The final rule will work to reduce competition and push health care prices higher — not lower — for American families, patients, and taxpayers,” Matt Eyles, president of America's Health Insurance Plans, said in a statement. "This is precisely the opposite of what Americans want in their health care." If the Trump rules withstand legal review, it’s unclear to what degree patients and their families will become a force reshaping the market.
Feds issue coverage plan for COVID-19 vaccine and treatments
Read full article: Feds issue coverage plan for COVID-19 vaccine and treatmentsThe regulations from the Centers for Medicare and Medicaid Services, or CMS, will also increase what Medicare pays hospitals for COVID-19 treatments. Under Wednesday's announcement:— Seniors with traditional Medicare will pay nothing for COVID-19 vaccines, and any copays and deductibles are waived. — The government will pay private Medicare Advantage plans to administer the vaccine to seniors. — Workplace and individual health insurance plans will cover the COVID-19 vaccine as a preventive service, with no cost sharing. — State Medicaid and Children's Health Insurance plans will have to provide vaccines for free for the duration of the coronavirus public health emergency.
Medicare finalizing coverage policy for coronavirus vaccine
Read full article: Medicare finalizing coverage policy for coronavirus vaccineWASHINGTON – Medicare will cover the yet-to-be approved coronavirus vaccine free for older people under a policy change expected to be announced shortly, a senior Trump administration official said Tuesday. It's questionable under normal circumstances if Medicare can pay for a drug that receives emergency use authorization from the Food and Drug Administration, as expected for the eventual coronavirus vaccine. A White House-backed initiative called “Operation Warp Speed” is pushing to have a vaccine ready for distribution in the coming months. States have already begun submitting their plans for vaccine distribution to the federal government. Initially, it's expected vaccines will go to people in high-risk groups such as medical personnel, frontline workers and nursing home residents and staff.
Virus shutdown took a toll on routine health care for kids
Read full article: Virus shutdown took a toll on routine health care for kidsFederal officials say a sharp decline in routine medical care for low-income children during the coronavirus shutdown will cause long-term harm if not reversed. (AP Photo/Alex Brandon, File)WASHINGTON – A sharp decline in routine medical care for low-income children during the coronavirus shutdown could cause long-term harm if not reversed, federal officials warned Wednesday. Among the findings:— Early childhood vaccinations declined by 22%, or 1.7 million fewer immunizations for kids up to age 2. — Even after accounting for increased use of telehealth, there were 6.9 million fewer mental health visits. The changes mirror what happened with everyday health care services for adults.
Report: Much needs doing to shield nursing homes from virus
Read full article: Report: Much needs doing to shield nursing homes from virusEarlier this summer, as COVID-19 rebounded across the South and West, 1 in 5 nursing homes faced PPE shortages. The administration says it has provided money for PPE and in August began shipping N95 masks to nursing homes that reported shortages. Nursing homes have been in lockdown since mid-March, and that has taken a toll on the well-being of residents. The commission recommended a detailed template for how nursing homes can safely resume visitation. The ravages of the coronavirus in nursing homes have surprised and shocked many people.
Dem report: Medicare chief used fed money to bolster image
Read full article: Dem report: Medicare chief used fed money to bolster imageThe consultants, many with Republican Party ties, billed taxpayers up to $380 per hour on work largely aimed at polishing the profile of Medicare administrator Seema Verma, the investigators wrote. The contractors were “handpicked” by Verma's aides, the report said, creating “a shadow operation" that sidelined the communications staff of the federal Centers for Medicare and Medicaid Services. “Congress did not intend for Administrator Verma or other senior CMS officials to use taxpayer dollars to stockpile CMS with handpicked consultants or promote Administrator Verma’s public profile and personal brand,” the report said. “Given the reckless disregard she has shown for the public’s trust, Administrator Verma should reimburse the taxpayers for these inappropriate expenditures,” it said. The report released Thursday was prepared by the Democratic staffs of two Senate and two House committees.
Fad or future? Telehealth expansion eyed beyond pandemic
Read full article: Fad or future? Telehealth expansion eyed beyond pandemicIn this Aug. 24, 2020, photo Jean Grady smiles as she poses at her home in Westford, Vt. Grady wears an insulin pump to help manage her diabetes. Before the pandemic, Medicare rules required her make regular two-hour, one-way trips to New Hampshire to meet with her doctor to discuss her treatment. Medicare rule changes during the pandemic now makes it possible for her to meet with her doctor remotely, saving her from hours on the road. (AP Photo/Wilson Ring)
Fad or future? Telehealth expansion eyed beyond pandemic
Read full article: Fad or future? Telehealth expansion eyed beyond pandemicBefore the pandemic, Medicare rules required her make regular two-hour, one-way trips to New Hampshire to meet with her doctor to discuss her treatment. (AP Photo/Wilson Ring)WASHINGTON Telehealth is a bit of American ingenuity that seems to have paid off in the coronavirus pandemic. Telehealth visits dropped with the reopening, but they're still far more common than before. As the government's flagship health care program, Medicare covers more than 60 million people, including those age 65 and older, and younger disabled people. Expanded Medicare telehealth could:help move the nation closer to a long-sought goal of treating mental health the same as physical conditions.
COVID-19 tests will now be required for nursing home staff
Read full article: COVID-19 tests will now be required for nursing home staffWASHINGTON Scrambling to check the spread of COVID-19 in nursing homes, the Trump administration announced Tuesday it will require facilities to test staff regularly or face fines. The move comes months after the White House first urged governors to test all nursing home residents and staff. With residents, nursing homes are being required to offer them coronavirus tests if there is an outbreak or if any show symptoms. If the positive rate is below 5%, nursing homes will have to test staff once a month. Mark Parkinson, head of the industry group American Health Care Association, said nursing homes in many parts of the country still can't get timely results on COVID-19 tests.
Pence defends outbreak response, pushes against shutdowns
Read full article: Pence defends outbreak response, pushes against shutdownsThey participated in a round-table with officials including Education Secretary Betsy DeVos and Centers for Medicare and Medicaid Administrator Seema Verma. The discussion came as reported positive case numbers in the state continue to rise, and South Carolina reported 56 coronavirus-related deaths, a near-record. State health officials tallied 1,203 new positive cases, for a total of 73,101 since the pandemic began. Were going to stay with you every step of the way until we put this virus in the past, Pence said to McMaster and other governors. How schools reopen is best left to local leaders, DeVos said, noting that plans would necessarily look different in various places.
Watchdog report faults Medicare agency's contract management
Read full article: Watchdog report faults Medicare agency's contract managementThe contracts, which are no longer active, were for strategic communications services, such as public engagement and interacting with the media. In a response that accompanies the report, she said CMS has deep concerns" with the conclusions, which are based on unsubstantiated assumptions and incomplete analysis." She also said the report relies on mischaracterizations of contractor tasks and duties and misrepresents federal acquisition rules. As head of CMS, Verma has enjoyed strong support from the White House but has clashed with health secretary Alex Azar. Vermas expansion of Medicare telehealth services may well be her most lasting accomplishment.
The Latest: India reimposes lockdown as cases near 1 million
Read full article: The Latest: India reimposes lockdown as cases near 1 millionSeveral Indian states imposed weekend curfews and locked down high-risk areas as the number of coronavirus cases surged past 900,000 on Tuesday. The latest figures released Tuesday show Bernalillo County, which includes the states most populous metro area, added another 65 confirmed cases. Utah has now recorded 226 confirmed deaths from COVID-19 and nearly 30,500 confirmed cases. ___JOHANNESBURG South Africa has surpassed the UK in its number of confirmed coronavirus cases. ___ATHENS, Greece The Greece government has ruled out a new lockdown after a rise in reported coronavirus infections since opening its borders.
Dems: Nursing home virus effort 'chronicle of deadly delay'
Read full article: Dems: Nursing home virus effort 'chronicle of deadly delay'The head of the Centers for Medicare and Medicaid Services, the lead federal agency on nursing homes, defended the administration's record. Statistics reported by nursing homes to the federal government as of June 14 show nearly 30,800 residents have died, according to an AP analysis. An AP count that includes nursing homes and other long-term care facilities finds nearly 52,500 deaths, combining residents and staff. Verma said CMS tried to help by changing its rules to allow labs to go into nursing homes and collect samples. CMS has impaneled a 25-member commission to analyze what happened in nursing homes and make recommendations to better protect elderly and frail residents.
Medicare data: Blacks likelier to be hospitalized for COVID
Read full article: Medicare data: Blacks likelier to be hospitalized for COVIDWASHINGTON Blacks were nearly four times more likely than whites to be hospitalized with COVID-19 among people with Medicare, the government said Monday. From Jan. 1-May 16, more than 325,000 Medicare recipients were diagnosed with COVID-19, and nearly 110,000 were hospitalized, according to the analysis of claims data. Low-income Medicare recipients who are also covered by their state Medicaid programs had a hospitalization rate that was slightly higher than the rate for African Americans. There were fewer COVID-19 cases and hospitalizations among Medicare recipients in rural areas, when compared to cities and suburbs. The Medicare data released Monday lack complete information about deaths, since they only record those who passed away in a hospital.
Grim blame game over COVID deaths in besieged nursing homes
Read full article: Grim blame game over COVID deaths in besieged nursing homesA grim blame game with partisan overtones is breaking out over COVID-19 deaths among nursing home residents, a tiny slice of the population that represents a shockingly high proportion of Americans who have perished in the pandemic. Advocates for the elderly say the federal government hasnt provided needed virus testing and sufficient protective gear to allow nursing homes to operate safely. With more coronavirus legislation possible this year, congressional Democrats are pressing for a national testing plan and additional resources for nursing homes. She says states have money from the federal government that they can use to support testing of nursing home staff. Rep. James Clyburn of South Carolina, the third-ranking House Democrat and chairman of a special panel on the pandemic, says the crisis in nursing homes should not be a partisan issue.
Outcry as some nursing homes try to grab stimulus checks
Read full article: Outcry as some nursing homes try to grab stimulus checks(Leah Millis/Pool via AP)WASHINGTON Compounding the hardships of the coronavirus, some nursing homes have demanded that low-income residents turn over their $1,200 economic stimulus checks, a cash grab lawmakers want to halt. Low-income Medicaid recipients must not be coerced into wrongly handing over their checks for fear of being kicked out of their homes, wrote Neal and Pallone. We are not aware of widespread issues with resident stimulus funds," the American Health Care Association said in a statement. Generally, a Medicaid recipients taxable income is taken into account in determining their eligibility for the program. CMS chief Seema Verma tweeted on Tuesday that nursing homes engaging in this behavior will be subject to enforcement action.
South Americas reopening and US protests could spread virus
Read full article: South Americas reopening and US protests could spread virusCemetery workers carry the coffin of Jorge Luis Collahua, during his burial in the section of Nueva Esperanza cemetery reserved for COVID-19 cases, in the outskirts of Lima, Peru, Monday, June 1, 2020. Its a start.But as Parisians reclaimed the rhythm of city life, health experts warned that virus cases are still rising in Latin America, the worlds latest COVID-19 epicenter. Clearly the situation in many South American countries is far from stable. South Africas coronavirus cases jumped again to more than 35,000 as the country began easing its lockdown. They said poor and middle-income countries, which represent nearly 70% of the worlds population, need immediate action.
Nearly 26,000 COVID deaths in nursing homes spur inspections
Read full article: Nearly 26,000 COVID deaths in nursing homes spur inspectionsFederal authorities arent setting any hard dates for when nursing homes can allow family members to visit again. We know that nursing homes have struggled, said Seema Verma, head of CMS, in a phone interview, Monday, May 18, 2020. Monday's report will add to the national soul-searching about the disproportionately high toll of the virus in nursing homes. Nursing homes rated at 1 or 2 stars in the government's 5-star rating system fared worse. Although the first wave of the pandemic may be easing in much of the country, that doesnt mean nursing homes are in any less danger.
Most Medicare enrollees could get insulin for $35 a month
Read full article: Most Medicare enrollees could get insulin for $35 a monthOlder adults who pick a drug plan offering the new insulin benefit would pay a maximum of $35 a month starting next year, a savings estimated at $446 annually. Verma, head of the Centers for Medicare and Medicaid Services, said 1,750 insurance plans that offer drug coverage to Medicare recipients have agreed to provide insulin for a maximum copay of $35 a month next year. Medicare's prescription drug benefit is offered by private insurers, either as a stand-alone Part D drug plan added to traditional Medicare, or as part of a managed care plan under Medicare Advantage. Medicare estimates that about 6 in 10 beneficiaries are already in prescription drug plans that will offer the new insulin benefit. The insulin benefit will be available in all 50 states, Washington, D.C., and Puerto Rico.
Watchdog cites persistent infection lapses in nursing homes
Read full article: Watchdog cites persistent infection lapses in nursing homesWASHINGTON Before COVID-19 killed thousands of nursing home residents, about 4 in 10 homes inspected were cited for infection control problems, according to a government watchdog report Wednesday that finds a persistent pattern of lapses. Nursing homes ended up bearing the brunt of the coronavirus outbreak. Data for that five-year period showed that 82% of nursing homes inspected, or 13,299, had at least one deficiency related to infection control and prevention. While about 40% of nursing homes nationwide were cited for infection control problems, the GAO found wide differences among states. The report also found that nonprofit nursing homes were somewhat less likely to be cited for persistent infection control problems.
Feds urge 'extreme caution' for reopening nursing homes
Read full article: Feds urge 'extreme caution' for reopening nursing homesThe Centers for Medicare & Medicaid Services criteria for relaxing restrictions at nursing homes come more than two months after the agency ordered homes to ban visitors. We know that nursing homes have struggled, Seema Verma, head of CMS, told The Associated Press. Already, outbreaks in nursing homes and long-term care facilities have claimed more than 33,000 lives, more than a third of all coronavirus deaths in the U.S., according to a count by the AP. Once visits resume, family members and others should still wear face coverings and practice social distancing, CMS said. For weeks, nursing homes have been calling on local and federal officials for help accessing tests and personal protective equipment.