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 "Humana":

"… n Minnesota retiree Doug Morphew needed surgery last year, he expected his Humana Medicare Advantage plan to step up and pay the lion’s share of the bill. …"

"… operation to repair an aortic aneurysm. Less than a month later, however, Humana hit him with a bill for $6,461.66, claiming the surgery was not covered be …"

"… ks part-time as a transportation industry consultant. “I am insulted by Humana’s runaround. It seems as though Humana is denying my claims hoping that …"

"… consultant. “I am insulted by Humana’s runaround. It seems as though Humana is denying my claims hoping that I will give up and pay the out-of-network …"

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 "Medicaid":

"… king new power to recover excessive charges. The Centers for Medicare and Medicaid Services says its wants to set up “a formal process to recoup overpaymen …"

Medicare Advantage lobbying machine steamrolls Congress

By Fred Schulte

Under pressure, Medicare Advantage critics morph into defenders.

Excerpts from this story referencing "federal government":

"… t mince words when he accused Medicare Advantage plans of overcharging the federal government — and praised legislation to slash their payments by billions of dollars …"

Medicare Advantage made simple: a glossary

By Fred Schulte

Definitions for lesser-known terms relating to Medicare.

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.

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 "Pharmaceutical Research and Manufacturers of America":

"… D. Bennett, senior vice president of communications and public affairs at Pharmaceutical Research and Manufacturers of America (PhRMA), wrote within hours of the speech: “The President’s proposal …"

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 "White House":

"… l industry. That’s because the industry’s friends in Congress (and the White House at the time) went along with Big Pharma’s demand that Medicare not be al …"

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

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

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 "Pfizer":

"… turers, the group counts several major pharmaceutical companies, including Pfizer, Roche and Johnson & Johnson, among its members.Regina Hall, AdvaMed's …"

"… g "vaccine shortage, safety, world health, and bioterrorism policy issues."Pfizer, the world's highest-grossing drug company, sponsored 12 trips valued at m …"

"… aux was working with House and Senate negotiators to draft the final bill, Pfizer flew him to New York for a one-day meeting.The trip was nothing new for Br …"

"… for Breaux, whose office accepted 15 trips — including six he took from Pfizer — from drug-makers and their allies. The portfolio of pharmaceutical tri …"

Drug industry influence timeline

What the pharmaceutical industry has gotten on its political investment

Excerpts from this story referencing "Food and Drug Administration":

"… he FDA.In late September, President George W. Bush signs into law the Food and Drug Administration Amendments Act (FDAAA) of 2007. The bill revises and extends the user-fee …"