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 "Walmart":

"… ing and the mail. It also has set up booths at some retail stores, such as Walmart, and sends sales agents to peoples’ homes — typically telling seniors …"

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 "Charles Grassley":

"… , an assistant professor at the University of Texas at Austin.  Sen. Charles Grassley, R-Iowa, said that refining the payment system to keep those costs in chec …"

Medicare Advantage lobbying machine steamrolls Congress

By Fred Schulte

Under pressure, Medicare Advantage critics morph into defenders.

Excerpts from this story referencing "Mitt Romney":

"… te floor in praise of the Affordable Care Act. Franken rebuked Republican Mitt Romney for his 2012 presidential campaign promise to “restore those billions an …"

Methodology for 'Medicare Advantage Money Grab'

By David Donald and Erin Durkin

A behind-the-scenes look at the data analysis for the 'Medicare Advantage Money Grab' investigation.

Excerpts from this story referencing "Health":

"… e-For-Service Data. Brian Biles, an MD and professor in the Department of Health Policy at George Washington University, and Giselle Casillas, an MPP and s …"

"… llment remains relatively stable that month. Because of regulations in the Health Insurance Portability and Accountability Act (HIPAA), small Medicare Advan …"

Medicare Advantage made simple: a glossary

By Fred Schulte

Definitions for lesser-known terms relating to Medicare.

Excerpts from this story referencing "CMS":

"… ther terms The Centers for Medicare and Medicaid Services: Referred to as CMS, this federal agency oversees Medicare and Medicaid, the government health …"

"… s Medicare and Medicaid, the government health plan for low income people. CMS is part of the Department of Health and Human Services. Dual Eligibles:&n …"

"… ent’s risk score— even if the health plan provides no added treatment. CMS officials proposed banning home visits for collecting risk data, but backe …"

"… unrecognized diseases that could boost risk scores and Medicare payments. CMS has proposed that health plans also report cases in which risk scores shou …"

OPINION: drug firms say no to rebates, despite billions in new revenue from Part D

By Wendell Potter

Part D brought drug companies billions, but they say the sky is falling

Excerpts from this story referencing "Reuters":

"… se companies can’t afford to pitch in to help bring Medicare costs down. Reuters estimates that drug makers take in about $300 billion a year in the United …"

"… s somehow make do with 5 or 6 percent or less. A Wall Street analyst told Reuters that reinstituting the rebate program could cost the drug companies 2 to 7 …"

OPINION: Big Pharma's stranglehold on Washington

By Wendell Potter

Pharmaceutical firms are getting their money's worth on Capitol Hill.

Excerpts from this story referencing "Medicine":

"… l Street analysts.   Each year, the Canadian government’s Patented Medicine Prices Review Board releases a study analyzing drug prices around the worl …"

Medicare: An entitlement out of control

By David Nather

If Congress had known in 1965 how expensive Medicare would become, it might not have approved the program in the first place. So Lyndon John

Excerpts from this story referencing "Obama administration":

"… e hospitals groups were powerful supporters of the legislation — and the Obama administration and Congress wanted to make sure they stayed that way — hospitals can’ …"

Medicare patients received expired, terminated drugs

By Joe Eaton

Medicare patients in 2006-07 likely received more than $112 million worth of expired prescription drugs or drugs that have been pulled from

Excerpts from this story referencing "Inspector General":

"… by the Government Accountability Office (GAO), various federal Offices of Inspector General (OIG), and other government entities. Congressional Research Service repor …"

GAO says Medicare regulator followed the rules in Humana smackdown

By Joe Eaton

The Government Accountability Office is siding with Medicare administrators in a dispute with Humana Inc.— the nation’s largest private heal

Drug makers' dime funds Congressional travel

By Robert Brodsky

Pharmaceutical companies, affiliated trade groups spent more than $600,000 on trips

Excerpts from this story referencing "Las Vegas":

"… ,000 on 84 trips, including pricey excursions to Europe, the Caribbean and Las Vegas.Leading the way was GlaxoSmithKline, the world's second-largest pharmaceut …"

Drug industry influence timeline

What the pharmaceutical industry has gotten on its political investment

Excerpts from this story referencing "Congressional Budget Office":

"… the manufacturer conducting studies of the drug's effects in children. The Congressional Budget Office estimates that, in the long run, prices for prescription drugs will increa …"