Today’s Hot Topics in Medicare News

10 Things to Know About Medicare Part D Coverage and Costs in 2019

BY JULIETTE CUBANSKI, ANTHONY DAMICO, and TRICIA NEUMAN: The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone prescription drug plans (PDPs) to supplement traditional Medicare and Medicare Advantage prescription drug plans (MA-PDs) that include drug coverage and other Medicare-covered benefits. This analysis provides the latest data about Medicare Part D coverage and costs in 2019 and trends over time. (read more)

House panel sets Medicare for all hearing for next week

BY JESSIE HELLMANN: The House Ways & Means Committee will hold a hearing next week on “Medicare for all,” the proposal that would shift the U.S. to a single-payer health care system.

The June 12 hearing will mark the first time the proposal is considered by a committee that has jurisdiction over health care issues. (read more)

6 Forces That Are Putting Medicare Enrollees in Play Now

BY ALLISON BELL: A major web broker, eHealth Inc., has pulled another batch of data out of its computers.

This time, eHealth is focusing on consumers who used its systems to buy coverage during the federal government’s first Medicare open enrollment period.

The new open enrollment period is really what amounts to a plan-switching period, for people who already have Medicare Advantage plan coverage. (read more)

Supreme Court Rules Against HHS in Medicare DSH Payment Case

BY JACQUELINE LAPOINTE: In a 7-1 decision released on Monday, the Supreme Court sided with hospitals that sued HHS in 2014 over a change in how the department calculated Medicare disproportionate share hospital (DSH) payments.

The justices affirmed a 2017 judgment from the Court of Appeals, in which current Supreme Court Justice Brett Kavanaugh ruled that HHS violated the Medicare Act by including Part C patients in the calculations of DSH payments without going through the notice-and-comment rulemaking procedures. (read more)

Medicare copays tied to early discharge in skilled nursing facilities

BY ERIN MICHAEL: With copayments starting on day 21, researchers found that Medicare beneficiaries were more commonly discharged on day 20 than on days 19 or 21, with those discharged at day 20 more likely to be racial/ethnic minorities and have lower socioeconomic status.

“Medicare pays for 100% of post-acute care provided by skilled nursing facilities (SNFs) during the first 20 days within a benefit period,” Paula Chatterjee, MD, MPH,of the division of general internal medicine at Perelman School of Medicine and the Leonard Davis Institute for Health Economics at the University of Pennsylvania, and colleague wrote in JAMA Internal Medicine. “However, on the 21st day, most patients become responsible for a daily copayment of more than $150.” (read more)


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