Medicare

Furor Erupts: Billions Going To Hospitals Based On Medicare Billings, Not COVID-19

Probably few hospital systems need the emergency federal grants announced this week to handle the coronavirus crisis as badly as Florida’s Jackson Health does.

Miami, its base of operations, is the worst COVID-19 hot spot in one of the most severely hit states. Even in normal years, the system sometimes barely makes money. At least two of its staff members have died of the virus.

But in a scathing letter to policymakers, system CEO Carlos Migoya said the way Washington has handled the bailout “could jeopardize the very existence” of Jackson, one of the nation’s largest public health systems, and similar hospital groups.

“We are here for you right now,” Migoya, who has tested positive for COVID-19 himself, said in a Thursday letter to Alex Azar, secretary of Health and Human Services. “Please, be here for us right now.”

Migoya and executives at other beleaguered systems are blasting the government’s

Read More

Pandemic Delays Federal Probe Into Medicare Advantage Health Plans

Federal health officials, citing a need to focus on the COVID-19 pandemic, have temporarily halted some efforts to recover hundreds of millions of dollars in overpayments made to Medicare Advantage health plans.

The Centers for Medicare & Medicaid Services says the decision will allow insurers and the agency to “focus on patient care,” and will last “until after the public health emergency has ended.”

Critics aren’t convinced that’s a wise idea.

“Some loosening of regulations during a crisis is necessary. But is this an abdication of oversight?” asked David Lipschutz, associate director and a senior policy attorney with the Center for Medicare Advocacy. “This is a serious concern we will have to grapple with at some point.”

Medicare Advantage plans are offered by private health insurers under contracts with Medicare. They treat more than 24 million Americans, most of them seniors at a relatively high risk of serious health complications

Read More