Today’s Hot Topics in Medicare News

Would ‘Medicare for All’ Save Billions or Cost Billions?

BY JOSH KATZ, KEVIN QUEALY, and MARGOT SANGER-KATZ: How much would a “Medicare for all” plan, like the kind being introduced by Senator Bernie Sanders on Wednesday, change health spending in the United States?

Some advocates have said costs would actually be lower because of gains in efficiency and scale, while critics have predicted huge increases.

We asked a handful of economists and think tanks with a range of perspectives to estimate total American health care expenditures in 2019 under such a plan. The chart at the top of this page shows the estimates, both in composition and in total cost. (read more)

Feds break up $1.2B Medicare orthopedic brace scam

BY ASSOCIATED PRESS: Federal authorities said Tuesday they’ve broken up a $1.2 billion Medicare scam that peddled unneeded orthopedic braces to hundreds of thousands of seniors via foreign call centers.

The Justice Department announced charges against 24 people across the U.S., including doctors accused of writing bogus prescriptions for unneeded back, shoulder, wrist and knee braces. Others charged included owners of call centers, telemedicine firms and medical equipment companies.

The Health and Human Services inspector general’s office said the fast-moving scam morphed into multiple related schemes, fueled by kickbacks among the parties involved. The FBI, the IRS, and 17 U.S. attorney’s offices took part in the crackdown. Arrests were made Tuesday morning.  (read more)

Bernie Sanders on the role of insurance companies under “Medicare for All”

BY CBS INTERACTIVE: Bernie Sanders is leading the polls in the packed field of 2020 Democratic candidates and while it’s more likely to see him out on the campaign trail these days, he’s back in the halls of Congress Wednesday to unveil an updated version of one of his signature proposals, “Medicare for All.” 

Once dismissed as too radical by many Democrats, it’s now central to how the party talks about health care and has become a common refrain of the Democratic presidential campaign. Four of his opponents in the race for president are co-sponsoring his universal health care plan in the Senate. But what is Medicare for All?

“It guarantees, like every other major country on Earth, health care to every man, woman and child in this country,” Sanders told CBS News’ Ed O’Keefe. (read more)

UnitedHealth To Expand Bundled Payments In Medicare Advantage

BY BRUCE JAPSEN: UnitedHealth Group said it will expand to its private Medicare Advantage plans an effort to pay doctors and hospitals for an array of surgeries and procedures by moving to bundled payments, a proliferating value-based care model.

UnitedHealth’s UnitedHealthcare is rolling out a new voluntary program that offers doctors and hospitals contracted with its Medicare Advantage plans in more than 30 states “the opportunity to participate in the value-based care payment program” for eight medical procedures including certain hip and knee joint replacements, spinal infusion, heart valve replacement and coronary bypass, according to the program announced Wednesday. Because the program is voluntary, UnitedHealthcare is pitching it to doctors and hospitals in coming months hoping they will participate effective Jan. 1, 2020. (read more)

New Medicare Advantage Benefits Offer Social Services to People with Chronic Illness

BY MELINDA K ABRAMS and SHAWN BISHOP: Amid court battles and contentious congressional hearings on other matters, the Trump administration released guidance last week that is good news for people with chronic conditions. Starting in 2020, Medicare Advantage plans — private health plans that contract with Medicare — will be allowed, but not required, to offer chronically ill enrollees nonmedical services for social needs that affect health. This is an important step for Medicare. Many older Americans, particularly those who are very sick, will greatly benefit given their high levels of unmet social needs.

Medicare Advantage plans will be able to select which nonmedical services they offer, as long as there is a “reasonable expectation that the services will help people with chronic conditions improve or maintain their health or overall function.” Examples of these services include: home-delivered meals, transportation for nonmedical needs, pest control, indoor air quality equipment (e.g., air conditioner for someone with asthma), and minor home modifications (e.g., permanent ramps, widening of hallways or doorways to accommodate wheelchairs).  (read more)

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