Susan Jaffe – Page 21 – Washington, D.C. reporter specializing in health policy and aging issues

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October 15, 2012, 6:00 AM KAISER HEALTH NEWS

Today, Medicare beneficiaries can begin choosing their drug and medical coverage for 2013, and most seniors are expected to stick with the same policies they have already, despite price changes and a rating system that shows some plans may be better than others. Seniors have been reluctant to change plans, even if there are cheaper or better-rated alternatives, according to recent studies and seniors advocates. Beneficiaries also tend to stay with the same insurers: This year more than a third of those in Medicare Advantage plans, which provide medical and drug coverage, chose policies from just two insurers, UnitedHealthcare or Humana.

The ratings are based on information reported by the plans, from Medicare records, and a yearly survey of some beneficiaries. Participation in the surveys is voluntary and anonymous but insurers are concerned that too many seniors opt out. [more]

Enrollment Season Opens For Medicare Advantage And Drug Plans

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Volume 380, Issue 9848, Pages 1133 – 1134, 29 September 2012

WORLD REPORT Comprehensive domestic health-care reform is one of the top defining issues in the campaign, overshadowing global health. Susan Jaffe reports from Washington, DC.

President Barack Obama and his rival Republican Mitt Romney would agree that the American health-care system is unsustainable, providing some of the world’s most expensive and yet fragmented care. But as they campaign for the presidency, the two candidates offer profoundly different solutions.

“The Affordable Care Act helps make sure you don’t have to worry about going broke just because one of your loved ones gets sick”, said Obama, describing his signature legislative achievement at a recent campaign stop in Colorado. “I don’t think a working mom in Denver should have to wait to get a mammogram just because money is tight”, he continued. “That’s why we passed this law. It was the right thing to do.” [more, as PDF]

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Volume 380, Issue 9846, 15 September 2012

WORLD REPORT Additional new health benefits for women began under the US Affordable Care Act last month, which experts hope will remain after the Nov 6 election. Susan Jaffe reports from Washington, DC.

Republican presidential candidate Mitt Romney promises to dismantle President Barack Obama’s landmark health-care reform law if elected. But as the presidential campaign progresses, various provisions of the law continue to kick into gear…. [more]
Panel: Abortion and the Aﬀordable Care Act

In the ﬁnal days of the congressional health reform debate, abortion coverage nearly derailed the legislation…. [more]

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Medicare pilot program meant to revise policy that leaves seniors with costly bill

By Susan Jaffe | August 9, 2012 | KAISER HEALTH NEWS produced in collaboration with

Concerned that a growing number of seniors have been unexpectedly forced to pay thousands of dollars for nursing home care after a stay in a hospital, Medicare has launched a pilot project to test whether it can relax hospital-payment rules to help the growing number of seniors who are shelling out thousands of dollars for follow-up nursing-home care.

The issue involves what should be an easy question: Is the Medicare beneficiary an inpatient or an observation patient? The answer can mean the difference between Medicare-covered follow-up nursing-home care or a senior facing an unexpected whopper of a bill. [Continued in The Washington Post and in KHN]

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MEDICARE TIP SHEET July 17, 2012 Published by Association of Health Care Journalists

Don’t look only to Washington policymakers for strategies to control medical costs and improve care for our aging population. New pilot projects that could accomplish these goals, which are at the heart of health reform, are being tested in communities across the country. In this tip sheet, reporter Susan Jaffe provides an overview of projects sponsored by the Center for Medicare and Medicaid Innovation, directs journalists to helpful resources and supplies an extensive list of potential story ideas. [access requires AHCJ membership or available on request here]

Latest Innovations in Medicare

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MEDSCAPE MEDICAL NEWS July 11, 2012

By Susan Jaffe

Washington, DC — As expected, the Republican-controlled US House of Representatives voted today 244 to 185, mostly along party lines, to repeal the Affordable Care Act (ACA) — for the 31st time. And once again, President Barack Obama promised to veto the legislation repealing his landmark health law should it reach his desk, which is unlikely, given the Democrat-controlled Senate. However, Republicans have several other strategies available to delay or block implementation of the law. MORE

Repeal Isn’t Only Way to Block Health Law, Says House GOP

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7 July 2012 lancet cover 2

The US Supreme Court decided last week that most provisions in the 2010 Patient Protection and Affordable Care Act were constitutional. Susan Jaffe reports from Washington, DC.

Last week’s historic ruling by the US Supreme Court preserving nearly all of President Barack Obama’s landmark health law may have finally settled some legal questions, only to shift a re-energised debate about improving the American health-care system to the political arena.In addition to providing health coverage to some 32 million uninsured Americans, other changes in the Patient Protection and Affordable Care Act will affect nearly every patient as it overhauls the US$2·7 trillion health-care system. MORE

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By Susan Jaffe | June 14, 2012 | KAISER HEALTH NEWS in partnership with

Billions of dollars in drug savings for Medicare beneficiaries may come to an end if the Supreme Court overturns the 2010 federal health law, a drug industry spokesman said Tuesday. The law provides “the necessary legal framework” for drug companies to slash brand-name drug prices by half for seniors and people with disabilities when they enter a coverage gap in their Medicare drug plans, said Matthew Bennett, a spokesman for the Pharmaceutical Research and Manufacturers of America. Eventually the discounts grow so that the gap, known as the doughnut hole, is closed by 2020. But if the law goes, the discounts may go, too.

More than 5.1 million Medicare beneficiaries enrolled in the Part D drug plans saved more than $3.2 billion on prescription drugs from March 2010 through December 2011 because of the health law provision, according to the Centers for Medicare & Medicaid Services. In the first four months of this year, seniors saved another $301.5 million. [MORE at msnbc] [MORE at Kaiser Health News]

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Volume 379, Issue 9828, Page 1775, 12 May 2012

The US Food and Drug Administration is calling for greater reliance on global partners to improve the safety of America’s foreign imports. Susan Jaffe reports from Washington, DC.

In its latest effort to promote a global strategy for protecting Americans against unsafe imported pharmaceutical, food, and medical products, the US Food and Drug Administration (FDA) has called for unprecedented international cooperation to cope with seemingly overwhelming challenges. FULL STORY

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By Susan Jaffe | May 10, 2012 | KAISER HEALTH NEWS in collaboration with

If a Medicare staff recommendation is approved, health insurance exchanges may be up for a rebranding.

Because, Medicare officials say, consumers understand words like “marketplace” better.

“We are recommending not using the word ‘exchange’” in enrollment materials, Julie Bataille, director of the CMS Office of Communications, said last week at a meeting of outreach advisers. And while she didn’t mention the preferred substitute, she dropped hints.

“Words like ‘marketplace’ resonate much more with the consumer and also tend to be something that is all inclusive,” she added. MORE

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By SUSAN JAFFE May 9, 2012, 3:51 PM

Belle Likover, a 92-year-old seniors advocate in Shaker Heights, Ohio, led the Ohio Department of Aging’s advisory council last year, and she is not easily deterred by government mumbo jumbo. Still, she

struggled to understand the summary of payments she recently received from Medicare after a five-day hospital stay.

“I don’t understand these codes,” she said. “There are five different doctors listed, and I have no idea who some of them are.”

There’s good news for anyone who, like Mrs. Likover, has ever tried to decipher one of the inscrutable statements, called Medicare summary notices, mailed quarterly to roughly 36 million beneficiaries. Starting next year, officials will begin using a new consumer-friendly format; it’s already available online at www.mymedicare.gov. The mysterious procedure codes are still there, but an easy-to-understand explanation of each service in larger type replaces the descriptions containing baffling abbreviations and medical terms. MORE

A Benefits Statement You Can Read

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$18 For A Baby Aspirin? Hospitals Hike Costs For Everyday Drugs For Some Patients

By Susan Jaffe | April 30, 2012 | KAISER HEALTH NEWS produced in collaboration with

For the price Diane Zachor, 66, was charged for one pill to control high pressure during her 18 hour stay at St. Luke’s Hospital In Duluth, Minn., she could have bought a three-week supply. In South Florida, Pearl Beras, 85, of Boca Raton, Fla., said her hospital charged $71 for one blood pressure pill for which her neighborhood pharmacy charges 16 cents. Several other Medicare patients in Missouri were billed $18 for a single baby aspirin, said Ruth Dockins, a senior advocate at the Southeast Missouri Area Agency on Aging.

It’s no mistake: When Medicare patients are in hospitals for observation, they can be charged any amount for routine drugs to treat chronic conditions such as diabetes, high blood pressure or high cholesterol. Medicare doesn’t cover these type of medications and doesn’t require hospitals to tell patients when they are in observation status or that they will be responsible for paying any non-Medicare-covered services.

“I just couldn’t believe some of these prices they charge,” said Zachor (left). “It’s just atrocious.” [More from USA Today or from Kaiser Health News]

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By Susan Jaffe and Kaiser Health News in partnership with

While many of the significant provisions of the 2010 health law don’t take effect until 2014, some key changes have kicked already kicked in. Our partners at Kaiser Health News consulted the agencies implementing the law to track how some of these new programs are going, and compared that data to the original projections of the nonpartisan Congressional Budget Office and the Obama administration. Much of the available data covers a limited period — usually through the end of 2011 or the fiscal year ending Sept. 2011. MORE

Scorecard: What The Health Law Has Delivered, Or Not

Appeals, CMS, Medicare, Medicare costs

Medicare Combats Fraud With Billing Statements That Beneficiaries Can Understand

Susan Jaffe | March 7, 2012 | KAISER HEALTH NEWS produced in collaboration with

In the latest effort to enlist seniors in the fight against Medicare fraud, federal officials have overhauled Medicare billing statements to make it easier to find bogus charges without a magnifying glass. ….And for those who might need an incentive to scour their bills, the new statements promise a reward of up to $1,000 for a tip that leads to uncovering fraud.[Continued here.]

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By Susan Jaffe | Feb. 9, 2012 | KAISER HEALTH NEWS in partnership with

The Obama administration Thursday unveiled final regulations detailing the new health insurance summaries that the federal health law requires plans to give to consumers to help them make informed coverage choices.

Mila Kofman, a research professor at Georgetown University… said that when consumers shop for insurance now, “co-insurance” or “annual deductible” may mean different things depending on the policy. Providing uniform information that’s easy to understand will empower consumers, she said.

“This will fundamentally change the way insurance is sold and the way is bought, and will make it much easier for consumers,” she said. [More from KHN or McClatchy]

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