Today’s Hot Topics in Medicare News

Imprisoned former R.I. lawmaker accused of Medicare and Medicaid fraud

BY KATIE MULVANEY: Less than a month after former state Sen. James E. Doyle II began serving time for scamming close to $500,000 from banks, the federal government is moving to recoup money authorities say he obtained through Medicare and Medicaid fraud.

U.S. District Court Chief Judge William E. Smith in April sentenced Doyle to serve two years in prison for passing tens of thousands of worthless checks among 20 bank accounts in a $74-million check-kiting scheme.

On May 15, Doyle, 47, of Pawtucket, began serving his sentence. He is now at the U.S. Penitentiary in Lewisburg, Pennsylvania, according to the U.S. Bureau of Prisons. (read more)

The Democrats who are still undecided on Medicare-for-all, explained

BY DYLAN SCOTT and LI ZHOU: House Democrats are holding their second-ever hearing on Medicare-for-all, as the party tries to sort out what its next big step on health care should be.

The Ways and Means Committee hearing on Wednesday differs from April’s historic hearing on Rep. Pramila Jayapal’s Medicare for All Act, which would cover every American in one government insurance plan, in two important ways: For one, it’s being held in a committee that actually has significant jurisdiction over health care policy, and two, the single-payer proposal is being reviewed alongside more incremental plans to expand health coverage. (read more)

Capping Seniors’ Out-Of-Pocket Prescription Drug Costs Could Increase Medicare Prices — And Premiums

BY AVIK ROY: Medicare’s prescription drug benefit is known as the one federal entitlement program that routinely comes in under budget. Now, a new push is on in Congress to make changes to the program that could increase costs.

Medicare’s unique drug benefit

Medicare, originally enacted in 1965, has many outdated design flaws. One of those was that the original law only covered prescription drugs if they were administered by a hospital (Medicare Part A) or in a physician’s office (Part B). Drugs that we obtain from retail pharmacies, like CVS or Walgreens, were not covered. (read more)

Do More Medicare Beneficiaries Enroll in Traditional Medicare Their First Year?

BY MANAGED HEALTHCARE EXECUTIVE: While enrollment in Medicare Advantage has grown rapidly over the past decade, the majority of Medicare beneficiaries choose to enroll in traditional Medicare during their first year on Medicare, according to the Kaiser Family Foundation (KFF).

A KFF Issue Brief found that older adults and younger beneficiaries with disabilities have said that they make this choice based on premiums and out-of-pocket costs, access to desired providers, the reputation of the company offering the plan, ads and other marketing materials, and the advice of brokers, family members, and friends. (read more)

Fix Medicare Before It Bankrupts the Country

BY MANAGED CARE: Forget Medicare for all, there may one day be Medicare for none if we don’t make systemic adjustments.

There are ways to keep the lid on Medicare spending before its becomes unsustainable argues John F. Early, in an op/ed in the Wall Street Journal. The life expectancy for an average 65-year-old has increased about 30% since 1967, the year after Medicare was launched. Early says that the eligibility age to receive Medicare should be gradually increased, so that by 2027 the full retirement age for both Medicare and Social Security will be 67.

There’s also been a fourfold increase since 1972 in the number of Americans qualifying for Medicare because of their disability status. (read more)

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