Author: Jaffe.KHN@gmail.com
Nursing Home Surprise: Advantage Plans May Shorten Stays to Less Time Than Medicare Covers
“The health plan can determine how long someone is in a nursing home typically without laying eyes on the person.”
By Susan Jaffe | Kaiser Health News | October 4, 2022 | This KHN story also ran on ![Fortune logo](https://i2.wp.com/khn.org/wp-content/uploads/sites/2/2019/03/fortune2019-logo.jpg?resize=106%2C25&ssl=1)
“This seems unethical,” said daughter Amy Loomis, who feared what would happen if the Medicare Advantage plan, run by UnitedHealthcare, ended coverage for her mother’s nursing home care. The facility gave Christopherson a choice: pay several thousand dollars to stay, appeal the company’s decision, or go home.
But instead of being relieved, Christopherson and her daughter were worried because her medical team said she wasn’t well enough to leave.
Health care providers, nursing home representatives, and advocates for residents say Medicare Advantage plans are increasingly ending members’ coverage for nursing home and rehabilitation services before patients are healthy enough to go home. [Full story in and Fortune, Kaiser Health News, The Philadelphia Inquirer, and Yahoo News]
…
FDA panel says preterm birth drug should be withdrawn
Volume 400, Issue 10362
29 October 2022
WORLD REPORT Makena has been given to hundreds of thousands of patients over the past 11 years. Susan Jaffe reports from Washington, DC.
The only treatment in the USA to prevent premature births is ineffective and should be withdrawn from the market, according to the Food and Drug Administration’s (FDA) Obstetrics, Reproductive and Urologic Drug Advisory Committee. The recommendation has renewed scrutiny of a special drug approval process that raises patients’ hopes by allowing them to take medications that have not been fully tested for efficacy and safety [Continued here.]
…Health organisations welcome US climate crisis law
Volume 400, Issue 10354
3 September 2022
WORLD REPORT The recently passed Inflation Reduction Act will provide billions of dollars of incentives to reduce greenhouse gas emissions. Susan Jaffe reports.
There are no emission limits or pollution penalties in the landmark Inflation Reduction Act that Congress approved in August. Instead of forcing cuts, the climate change and healthcare law provides US$370 billion worth of incentives to ratchet down the planet-warming greenhouse gases from fossil fuels that have caused record-breaking heat waves, wild fires, droughts, and floods. …The law provides $60 billion for communities that have been disproportionately affected by toxic hazards and the consequences of climate change. [Continued here.]
…US Congress lets Medicare negotiate lower drug prices
Volume 400, Issue 10352
20 August 2022
WORLD REPORT A new law also targets climate change in a major victory for Democrats and President Joe Biden. Susan Jaffe reports from Washington, DC.
“Chaos” for patients and providers after US abortion ruling
Volume 400, Issue 10346
9 July 2022
WORLD REPORT A patchwork of state laws replace abortion rights once guaranteed by Roe v Wade. Susan Jaffe reports from Washington, DC.
…
Federal abortion rights end, but not legal challenges
Volume 400, Issue 10345
2 July 2022
…
Medicaid Weighs Attaching Strings to Nursing Home Payments to Improve Patient Care
US Infant formula crisis increases scrutiny of the FDA
Volume 399, Issue 10347
11 June 2022
WORLD REPORT Both Republican and Democrat legislators have called for changes following a shortage of breastmilk substitute. Susan Jaffe reports from Washington, DC..
The leading US producer of infant formula resumed partial operations on June 4 following a 4-month shutdown, but it may take several more weeks before supplies return to normal, along with the shortage-induced panic and desperation of American parents. When the US Food and Drug Administration (FDA) can regain trust in its ability to police the nation’s food manufacturers is another matter.
The agency’s failure to respond quickly to health hazards at the Abbott Nutrition facility in Sturgis, MI, that released potentially contaminated formula across the country has provoked rare bipartisan outrage in Congress and equally rare apologies from the manufacturer. The shutdown and resulting shortage have also prompted calls for major changes in the FDA’s food safety division, along with questions about why one supplier dominates the market. [Continued here.]
…
Raj Panjabi: bringing a global outlook to the US pandemic response
Volume 399, Issue 10338
14 May 2022
PROFILE Raj Panjabi
In February, 2022, US President Joe Biden appointed global health physician and epidemiologist Raj Panjabi as a Special Assistant to the President and Senior Director for Global Health Security and Biodefense at the White House National Security Council in Washington, DC, which advises Biden on foreign policy and security issues.[Continued here.]…
Medicare Surprise: Drug Plan Prices Touted During Open Enrollment Can Rise Within a Month
By Susan Jaffe | Kaiser Health News | May 3, 2022 | This KHN story also ran on ![](https://i0.wp.com/susanjaffe.org/wp-content/uploads/2015/12/nprlogo_112x37-e1575841349947.gif?resize=80%2C26)
… Health organizations fear effects of US abortion ruling
Volume 399, Issue 10338
14 May 2022
WORLD REPORT Health and human rights groups are concerned that many states would outlaw abortion if the Supreme Court topples Roe v Wade. Susan Jaffe reports.
Protests and celebrations erupted across the USA following the unprecedented leak of a draft Supreme Court decision that would overturn the court’s 1973 landmark Roe v Wade ruling establishing a woman’s right to a safe and legal abortion. …“States are already working together to create enormous abortion deserts that many people will not be able to cross”, said Nancy Northup, president and CEO of the Center for Reproductive Rights. [Continued here.]
…
Medicare covers new Alzheimer’s drug, but there is a catch
Volume 399, Issue 10335
23 April 2022
WORLD REPORT The federal health plan for older Americans will pay for the controversial new drug aducanumab only for patients participating in clinical trials. Susan Jaffe reports.
…
Califf takes the helm at the US FDA, again
Volume 399, Issue 10330
19 March 2022
WORLD REPORT Robert Califf will have to face several controversial health issues in his second tenure as commissioner. Susan Jaffe reports from Washington, DC.
election results could shrink, if not eliminate, the Democratic majority President Joe Biden needs to propel his health agenda, including the relaunched cancer moonshot and the Advanced Research Projects Agency for Health that would accelerate the development of medical treatments. [Plus new COVID-19 tests and treatments, opioid misuse, accelerated approval process, abortion pill conflict, continued here.]
Seeking to Shift Costs to Medicare, More Employers Move Retirees to Advantage Plans
By Susan Jaffe | Kaiser Health News | March 3, 2022 | This KHN story also ran in Fortune and The Dallas Morning News.
…Biden’s science adviser resigns over bullying
Volume 399, Issue 10326
19 February 2022
WORLD REPORT Experts say that Eric Lander’s resignation should not affect the President’s plans to reboot the cancer moonshot project. Susan Jaffe reports.…
Medicare Patients Win the Right to Appeal Gap in Nursing Home Coverage
The next steps for US vaccine mandates
Volume 399, Issue 10323
28 January 2022
WORLD REPORT As the Supreme Court blocks one of the Biden Administration’s plans to raise COVID-19 vaccination rates but approves another, Susan Jaffe looks at the next steps.
…
Holmes verdicts prompt questions over justice for patients
Volume 399, Issue 10321
15 January 2022
WORLD REPORT The founder of Theranos was found guilty of defrauding some investors, but cleared of charges that she misled patients. Susan Jaffe reports.
US Supreme Court expected to weaken abortion rights
Volume 398, Issue 10317
11 December 2021
WORLD REPORT The US Supreme Court, now dominated by conservatives, heard arguments last week on the legality of a Mississippi law banning abortion after 15 weeks of pregnancy. However, the justices signalled that they are likely to do more than uphold the law. .[Continued here.]
…
Theranos founder counters fraud charges in federal trial
Volume 398, Issue 10315
27 November 2021
WORLD REPORT Federal prosecutors charged Theranos’ founder Elizabeth Holmes and former Theranos president Ramesh Balwani with wire fraud and conspiracy to commit wire fraud, alleging that they deceived investors and patients and their doctors by claiming that Theranos’s machine could produce accurate test results from blood collected in its tiny “nanotainer” device instead of several vials. But witnesses for the prosecution testified that the devices did not operate as promised…. “When something is brought forward as the next new thing regardless of whether it’s a drug or device, it needs to go through the process of rigorous scientific and clinical testing, then presented to the scientific community for peer review and ultimately publication”, said Roy Silverstein a haematologist and chair of medicine at the Medical College of Wisconsin. “And I’m not aware of any single publication that ever came out of this Theranos technology.” [Full story here.]
…Legal challenges threaten Biden’s COVID-19 vaccine rule
Volume 398, Issue 10314
20 November 2021
WORLD REPORT Almost a year after the first COVID-19 vaccine was approved for emergency use in the USA, roughly a third of adults have still not received it. After urging Americans to get vaccinated, US President Joe Biden has taken a tougher approach: under his administration’s new workplace safety standard, people must get vaccinated or undergo weekly tests for the virus if they work for companies with at least 100 employees. “The rule will protect more than 84 million workers from the spread of the coronavirus on the job”, said Jim Frederick, Deputy Assistant Secretary of Labor for Occupational Safety and Health. …A day after OSHA’s announcement on Nov 4, 2021, multiple lawsuits to block the rule started rolling in to federal courts across the country.[Continued here.]
…
Medicare’s Open Enrollment Is Open Season for Scammers
By Susan Jaffe | Kaiser Health News | November 11, 2021 | This KHN story also ran in The Washington Post.
In response, the Centers for Medicare and Medicaid Services has threatened to penalize private insurance companies selling Medicare Advantage and drug plans if they or agents working on their behalf mislead consumers. The agency has also revised rules making it easier for beneficiaries to escape plans they didn’t sign up for or enrolled in only to discover promised benefits didn’t exist or they couldn’t see their providers.
The problems are especially prevalent during Medicare’s open-enrollment period, which began Oct. 15 and runs through Dec. 7. A common trap begins with a phone call like the one Linda Heimer, an Iowa resident, received in October. [Full story in The Washington Post and Kaiser Health News.]
3 States Limit Nursing Home Profits in Bid to Improve Care
“If they choose to rely on public dollars to deliver care, they take on a greater responsibility,” says New York Assemblyman Ron Kim. “It’s not like running a hotel.”
By Susan Jaffe | KAISER HEALTH NEWS | October 25, 2021 | This story also ran on![](https://i1.wp.com/susanjaffe.org/wp-content/uploads/2021/10/Fortune-300x97.png?resize=100%2C32)
Nursing homes receive billions of taxpayers’ dollars every year to care for chronically ill frail elders, but until now, there was no guarantee that’s how the money would be spent.
Massachusetts, New Jersey and New York are taking unprecedented steps to ensure they get what they pay for, after the devastating impact of covid-19 exposed problems with staffing and infection control in nursing homes. The states have set requirements for how much nursing homes
must spend on residents’ direct care and imposed limits on what they can spend elsewhere, including administrative expenses, executive salaries and advertising and even how much they can pocket as profit. …With this strategy, advocates believe, residents won’t be shortchanged on care, and violations of federal quality standards should decrease because money will be required to be spent on residents’ needs. At least that’s the theory. [Continued on Kaiser Health News, Fortune, NBC News, Yahoo Finance, and Chicago Sun-Times]…
The Push For Nursing Home Reform In The Middle Of A Pandemic
Sept. 20, 2021 | Today on NPR‘s news program “1A,” reporter Susan Jaffe discusses her Kaiser Health News story about new state laws protecting nursing home residents in response to the COVID-19 pandemic. Changes affect staffing, visitation rights, virtual communications, “essential support persons,” and more. A resident of a Connecticut nursing home quoted in this KHN article is also a guest. …