Don't wait 'til last minute to enroll in Obamacare

By Wendell Potter

Not all health insurance plans are created equal. Shoppers should get to work now on finding the right policy.

Excerpts from this story referencing "Congress":

"… atus quo for health insurers. They do so by making sure certain members of Congress don’t even think about giving us the choice and competition that would r …"

Court case pushed by think tank could leave uninsured out in the cold

By Wendell Potter

Supreme Court case backed by think tank hinges on single sentence in Affordable Care Act.

Obama administration let opponents define the Affordable Care Act

By Wendell Potter

Commentary: Obama administration let foes define Affordable Care Act.

Health insurers win midterm election!

By Wendell Potter

Commentary: midterm results create a friendlier Congress.

Excerpts from this story referencing "Health":

"… re prices of five of the six largest for-profit Health insurers — Cigna, Health Net, Humana, UnitedHealthcare and WellPoint/Anthem — reached their highe …"

"… ix largest for-profit Health insurers — Cigna, Health Net, Humana, UnitedHealthcare and WellPoint/Anthem — reached their highest points in a year last W …"

"… d — and in some cases even tripled. If you had invested $25,000 in UnitedHealthcare stock in 2010, you would have $78,750 today, a 315 percent return. Bu …"

"… in: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans and Obamacare: What’s in It for M …"

More scrutiny coming for Medicare Advantage, Obamacare

By Fred Schulte

New round of audits coming; Obamacare too.

Excerpts from this story referencing "Congress":

"… Advantage program has grown rapidly under the risk-scoring formula, which Congress enacted in 2003. Officials expect Medicare Advantage to cost taxpayers as …"

Another whistleblower suit alleges Medicare Advantage fraud

By Fred Schulte

California litigation alleges 'house calls" yielded false claims

Excerpts from this story referencing "Health Net":

"… ; WellPoint, Inc., which operates  Anthem Blue Cross and Blue Shield; Health Net of California, Inc. and Alameda Alliance for Health.  None would comm …"

GAO takes on Medicare Advantage spending

By Fred Schulte

GAO will investigate program spending.

Excerpts from this story referencing "Medicaid Services":

"… spring. GAO auditors will target efforts by the Centers for Medicare and Medicaid Services (CMS), which runs the senior care program, to ensure the privately run hea …"

Comparison shopping for a health plan

By Wendell Potter

California makes it easy to do your homework.

Excerpts from this story referencing "Health":

"… plans, you can go to Healthcare.gov, maintained by the U.S. Department of Health and Human Services, or a private online source like Healthinsurance.org, w …"

"… patient experience. They were followed by Blue Shield of California, Sharp Health Plan (in greater San Diego), and Western Health Advantage (in the Sacramen …"

"… hield of California, Sharp Health Plan (in greater San Diego), and Western Health Advantage (in the Sacramento area). All of those plans are also nonprofits …"

"… ts. The plans with the fewest stars were Aetna, Anthem Blue Cross, Cigna, Health Net and UnitedHealthcare of California, all for-profit companies. Convers …"

A call for more scrutiny of private Medicare Advantage plans

By Fred Schulte

Researchers say aggressive billing by private plans may require more scrutiny

Excerpts from this story referencing "Health":

"… “upcoding.” Researcher Richard Kronick, director of the Department of Health and Human Services’ Agency for Healthcare Research and Quality, said off …"

"… ick, director of the Department of Health and Human Services’ Agency for Healthcare Research and Quality, said officials should consider tightening audit …"

"… ed to kill or scale back planned pay cuts to the Health plans. America’s Health Insurance Plans, the industry’s primary trade group, spent nearly $5 mil …"

"… p overpayments. Clare Krusing, director of communications for America’s Health Insurance Plans, did not respond directly to a question about the payment …"

California coverage plan for undocumented echoes earlier call by Schwarzenegger

By Wendell Potter

Commentary: former governor supported plan allowing coverage for undocumented residents.

Excerpts from this story referencing "Congress":

"… rmer California Governor Arnold Schwarzenegger, a Republican, Democrats in Congress decided as they worked on health care reform that providing coverage to th …"

Obamacare helps millions, but falls short in many ways

By Wendell Potter

The Affordable Care Act has reduced the ranks of the uninsured, but cost of care must be addressed.

Excerpts from this story referencing "Washington":

"… born with. During the months that health care reform was being debated in Washington, I met many young people who told me they had not been able to buy an insu …"

"… were not willing to do in 2009 because of the political clout they have in Washington. Consequently, much more reform will have to be undertaken in years to com …"

New types of health care delivery are improving the 'patient experience'

By Wendell Potter

Commentary: eliminating role of insurers could improve health care delivery.

Health insurers turning into who knows what?

By Wendell Potter

Commentary: health insurers are transforming themselves — but into what?

Excerpts from this story referencing "Insurance":

"… cessity.   Wendell Potter is the author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and …"

Defeat of California initiative would protect insurers' profits

By Wendell Potter

Proposition 45 would allow California's insurance chief to block insurance rate hikes; insurers are spending millions to kill it.

Excerpts from this story referencing "Los Angeles Times":

"… han to cover expected increases in medical costs.   According to the Los Angeles Times, a recent poll showed that 69 percent of registered California v …"

Docs, drug companies, insurers drive up Medicare costs

By Wendell Potter

Commentary: reform drove down hospital costs, creating Medicare savings, but insurers, doctors and drug companies escaped cuts.

Excerpts from this story referencing "Congress":

"… until 2030 — 13 years later than projected in 2009, the year before Congress passed the Affordable Care Act. While it’s uncertain how much of that g …"

"… hts Center and Social Security Works — released a report suggesting that Congress could save taxpayers $141 billion over 10 years just by reauthorizing a pr …"

"… in the first year of the Part D program. The groups also recommended that Congress allow Medicare to create its own drug insurance plan that could directly n …"

"… s also contributed to soaring health care costs, especially for Medicare. Congress has also allowed health insurers to enrich themselves, in both lawful and …"

Medicare Advantage patients find themselves in regulatory limbo

By Fred Schulte

States lack oversight but feds are struggling to keep with fast-growing health plans.

Excerpts from this story referencing "Medicaid":

"… formal complaint, and about two dozen others, to Centers for Medicare and Medicaid Services (CMS) administrator Marilyn B. Tavenner. Swanson asked the federa …"

Dire predictions of endless waits for a doctor have proven unfounded

By Wendell Potter

Commentary: Obamacare has not resulted in long waits for a doctor.

Excerpts from this story referencing "Congress":

"… ge would be alleviated, the AAMC says, if rather then repealing Obamacare, Congress would lift a freeze in Medicare’s support for physician-training positio …"

Ten major findings from our investigations so far this year

By Jared Bennett and Sarah Whitmire

Investigations from the first half of 2014

Excerpts from this story referencing "Comcast":

"… ished. Keep reading 9. Only 12% of eligible households have signed up for Comcast's affordable Internet program Back in 2011, Comcast wanted to ease feder …"

"… s have signed up for Comcast's affordable Internet program Back in 2011, Comcast wanted to ease federal approval of its merger with NBC Universal, so it pr …"

"… es. The program, called "Internet Essentials," helped show regulators that Comcast's corporate deal was in the public interest (and it made for good public r …"

"… s in the public interest (and it made for good public relations, too). Now Comcast wants to buy Time Warner, and this new merger begs the question — what h …"

How Medicare Advantage plans code for cash

By Fred Schulte

Federal study criticizes Medicare Advantage and calls for changes.

Excerpts from this story referencing "Congress":

"… Further policy changes will likely be necessary,” the study concludes. Congress created Medicare Advantage in 2003 to encourage private insurance companie …"

"… stry and the fear of angering seniors also has largely quieted concerns in Congress that Medicare Advantage plans can be a poor value for taxpayers. Congress …"

"… Congress that Medicare Advantage plans can be a poor value for taxpayers. Congress recognized problems with Medicare Advantage coding as far back as 2005, wh …"

Obamacare-driven competition lowering rates in some states

By Wendell Potter

Commentary: much-maligned Affordable Care Act attracting for-profit insurers, driving prices down in some states.

Excerpts from this story referencing "UnitedHealth Group":

"… ng in, at least where they think they can make money. Leading the pack is UnitedHealth Group, the country’s biggest health insurer. The company offered 2014 policies …"

Attack ads may actually be benefiting Obamacare enrollment

By Wendell Potter

Publicity from attacks may actually help hike enrollment.

Excerpts from this story referencing "Wall Street Journal":

"… at they’ve heard in the media. KFF president Drew Altman wrote in a Wall Street Journal column last Tuesday (“Why the Political Heat on the ACA is Cooling …"

Feds seek new authority to recoup Medicare Advantage overcharges

By Fred Schulte

Impact: Feds act to recoup overcharges following Center investigation.

Excerpts from this story referencing "spokeswoman":

"… rule is made. “We are evaluating the proposal,” said Clare Krusing, a spokeswoman for America’s Health Insurance Plans, the industry’s trade group. Cong …"

Medicare Advantage plans require more scrutiny

By Fred Schulte

Government inspector says private Medicare plans difficult to investigate due to lack of access to data.

Excerpts from this story referencing "House Committee on Energy and Commerce":

"… mony prepared for a Wednesday hearing of the oversight subcommittee of the House Committee on Energy and Commerce. The hearing was called to assess fraud and abuse safeguards in Medicare, …"

Praise for UK-style health system vindicates spurned nominee

By Wendell Potter

Former Medicare chief's support for UK's health care system may win votes in race for governor of Massachusetts.

Excerpts from this story referencing "Medicare":

"… dely respected physician and health policy expert, to lead the Centers for Medicare and Medicaid Services (CMS). Despite having broad support among other heal …"

Health insurance lobby keeps Medicare Advantage overpayments flowing

By Wendell Potter

Commentary: program bills are excessive, but don't expect reforms.

Excerpts from this story referencing "New York":

"… a day of lobbying — coordinated by AHIP.   Even Charles Schumer of New York, who chaired the Democratic Senatorial Campaign Committee from 2005-2009 a …"

Get involved: Help Medicare Advantage investigation go further with donations and news tips

Join us in finding problems with Medicare Advantage billing, “risk scores”, or home visits.

Excerpts from this story referencing "District of Columbia":

"… a result, the Center filed suit against HHS in U.S. District Court of the District of Columbia in late May. The series is reported by Center reporter Fred Schulte, with …"

Home is where the money is for Medicare Advantage plans

By Fred Schulte

Medicare Advantage home visits may not improve health, but boost risk scores and cost taxpayers billions.

Excerpts from this story referencing "Medicaid":

"… posal to restrict these visits. Officials at the Centers for Medicare and Medicaid Services in Washington refused numerous requests for comment and declined …"

"… driving up Medicare’s costs. In February 2013, Centers for Medicare and Medicaid Services officials proposed flagging diagnoses written up from a home visi …"

Medicare Advantage lobbying machine steamrolls Congress

By Fred Schulte

Under pressure, Medicare Advantage critics morph into defenders.

Excerpts from this story referencing "House Committee on Energy and Commerce":

"… In a March 2014 memo to its members, the Democratic staff of the House Committee on Energy and Commerce accused the Medicare Advantage industry of making “exaggerated claims” …"

Skyrocketing salaries for health insurance CEOs

By Wendell Potter

Commentary: soaring compensation, rising stock prices don't justify higher premiums.

Excerpts from this story referencing "WellPoint":

"… -S Management Corp., UnitedHealth Group, Universal American, Wellcare, and WellPoint) nine saw their stocks close near 52-week highs this past Friday. The big …"

"… e is up 31 percent, Cigna’s 32 percent. United’s is up 28 percent. And WellPoint’s is up 39 percent. But it is the CEO compensation that has been the mo …"

Health insurers have their way with regulators

By Fred Schulte

Billions in Medicare Advantage overpayments likely gone for good.

Excerpts from this story referencing "Cigna":

"… d they can lose money when risk-based payments don’t cover their costs. Cigna Healthcare of Arizona, for example, disputed the audit finding that it was …"

"… an $23 million for 2007. Calling the audit standards “fatally flawed,” Cigna said it actually lost about $800,000 that year treating the 100 patients w …"

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