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Medicare

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SAN FRANCISCO (AP) — The federal government has sued Kaiser Permanente, alleging the health care giant committed Medicare fraud and pressured doctors to list incorrect diagnoses on medical records in order to receive higher reimbursements, officials said Friday.

Medicare Part B covers ambulance transportation to a health care facility when it’s medically necessary and transportation in any other vehicle would endanger your health. The tricky part is judging…

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WASHINGTON (AP) — Stinging from the disappointment of Bernie Sanders' loss in the 2016 Democratic presidential primary, supporters pumped millions into the powerful advocacy group Our Revolution to keep the progressive fight alive and prepare for another swing at the White House.

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WASHINGTON (AP) — Senate Majority Leader Chuck Schumer pressured lawmakers Thursday to reach agreement by next week on a pair of massive domestic spending measures, signaling Democrats’ desire to push ahead aggressively on President Joe Biden’s multitrillion-dollar agenda.

Democrats in Congress reached a tentative agreement to press ahead on a partisan bill that would dramatically expand health benefits for people on Medicare, those who buy their own insurance and individuals who have been shut out of coverage in states that didn’t expand Medicaid. Meanwhile, controversy continues to rage over whether vaccinated Americans will need a booster to protect against covid-19 variants, and who will pay for a new drug to treat Alzheimer’s disease. Rachel Cohrs of Stat and Sarah Karlin-Smith of the Pink Sheet join KHN’s Julie Rovner to discuss these issues and more. Also, Rovner interviews KHN’s Rae Ellen Bichell, who reported and wrote the latest KHN-NPR “Bill of the Month” episode about a mother and daughter who fought an enormous emergency room bill.

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WASHINGTON (AP) — President Joe Biden made a quick foray to the Capitol on Wednesday hunting support for his multitrillion-dollar agenda of infrastructure, health care and other programs, a potential landmark achievement that would require near-unanimous backing from fractious Democrats.

In an interview for KHN’s “What the Health?” podcast, HHS Secretary Xavier Becerra says the administration is eager for Congress to make changes to Medicare that will provide more benefits and make more older adults eligible for the program. He also said a priority will be making permanent the enhanced premium subsidies for Affordable Care Act marketplace plans.

WASHINGTON (AP) — Medicare on Monday launched a formal process to decide whether to cover Aduhelm, the new Alzheimer's drug whose $56,000-a-year price tag and unproven benefits have prompted widespread criticism and a congressional investigation.

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ATLANTA (AP) — The Biden administration's decision to reevaluate Georgia's plan to overhaul how state residents buy health insurance under the Affordable Care Act came as a “surprise” and suggests it wants to revisit the plan's approval, which is not allowed, Gov. Brian Kemp's office said.

Original Medicare doesn’t cover most dental care or services, including dental implants, although there may be cases where Medicare will cover part of the dental costs related to an inpatient…

FRANKFORT, Ky (AP) — State Rep. Attica Scott, one of two Black women in Kentucky's legislature, announced Wednesday that she'll try to unseat longtime Democratic Congressman John Yarmuth in the state’s only congressional district controlled by Democrats.

The Biden administration is moving to undo many of the changes the Trump administration made to the enrollment process for the Affordable Care Act, in an effort to encourage more people to sign up for health insurance. Meanwhile, Congress is opening investigations into the controversial approval by the Food and Drug Administration of an expensive new drug that might or might not slow the progression of Alzheimer’s disease. Joanne Kenen of Politico, Kimberly Leonard of Insider and Sarah Karlin-Smith of The Pink Sheet join KHN’s Julie Rovner to discuss these issues and more. Also, Rovner interviews Marshall Allen of ProPublica about his new book, “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win.”

Democrats in Congress and the states are devising strategies to expand health coverage — through the Affordable Care Act, Medicare, Medicaid and a “public option.” But progress remains halting, at best. Meanwhile, lawmakers in Washington may have to agree on how to control prescription drug prices if they wish to finance their coverage initiatives. Alice Miranda Ollstein of Politico, Tami Luhby of CNN and Shefali Luthra of The 19th join KHN’s Julie Rovner to discuss these issues and more. Also, Rovner interviews Michelle Andrews, who reported and wrote last month’s KHN-NPR “Bill of the Month” episode about a very expensive sleep study.

In a surprisingly strong 7-2 decision, the Supreme Court turned back the latest constitutional challenge to the Affordable Care Act, likely heralding the end of GOP efforts to strike the law in its entirety through court action. Meanwhile, Democratic lawmakers are looking for ways to expand health benefits. Joanne Kenen of Politico, Mary Ellen McIntire of CQ Roll Call and Rachel Cohrs of Stat join KHN’s Julie Rovner to discuss these issues and more. Also, Rovner interviews Andy Slavitt, who recently stepped down from the Biden administration’s covid response team, about his new book on the pandemic.

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