Today’s Hot Topics in Medicare News

Uber Taps Lucrative Medicare Business With Logistics Deal

BY BRUCE JAPSEN: Uber has signed a contract with a key medical transportation company that has relationships with some of the nation’s biggest health insurers.

Uber Health, the healthcare business of the ride-sharing giant, said it is partnering with American Logistics Company in “the rideshare company’s first national collaboration with a healthcare transportation management company.” Financial terms of the partnership weren’t disclosed(read more)

Trump Administration Hits Brakes On Law To Curb Unneeded Medicare CT Scans, MRIs

BY PHIL DALEWITZ: Five years after Congress passed a law to reduce unnecessary MRIs, CT scans and other expensive diagnostic imaging tests that could harm patients and waste money, federal officials have yet to implement it.

The law requires that doctors consult clinical guidelines set by the medical industry before Medicare will pay for many common exams for enrollees. Health care providers who go way beyond clinical guidelines in ordering these scans (the 5% who order the most tests that are inappropriate) will, under the law, be required after that to get prior approval from Medicare for their diagnostic imaging. (read more)

How Health Policy is Working to Reduce Medicare Drug Spending

BY KELSEY WADDILL: As healthcare costs continue to escalate, policymakers have put forth numerous solutions to control Medicare drug spending and, through it, stabilize the healthcare economy, a recent Kaiser Family Foundation (KFF) study explained.

Current drug prices propel the healthcare industry’s rising medical cost trend, projected to rise six percent in 2020. Medicare is not immune, accounting for 30 percent of the nation’s retail prescription drug spending in 2017, according to a separate study conducted by KFF. The costs are projected to rise 4.6 percent per enrollee over the next decade. (read more)

Half Of Big U.S. Employers Favor Expanding Medicare

BY BRUCE JAPSEN: More than half of large U.S. employers favor expanding Medicare to make more Americans under 65 eligible for such health insurance coverage, a new national business coalition’s survey shows.

The National Business Group on Health says more than half of these employers favor expanding Medicare to those ages 60 to 64 or to those as young as 50. The survey said 23% of large employers supported Medicare expansion “but only for ages 60 – 64” while another 23% favor Medicare expansion “but only for ages 50 to 64.” (read more)

Hospitals call for overhauling Medicare Advantage prior authorization rules

BY SUSANNAH LUTHI: Hospitals and health systems are demanding that the CMS set national rules for how insurers manage prior authorization and payment for pre-approved claims in Medicare Advantage.

In response to the Trump administration’s request for information on its Patients over Paperwork initiative to cut Medicare red tape, hospitals complained that prior authorization is a complicated system where payment isn’t guaranteed even if they follow all the steps insurers lay out for them. (read more)

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