Susan Jaffe – Page 22 – Washington, D.C. reporter specializing in health policy and aging issues

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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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By Susan Jaffe | January 24, 2012 | KAISER HEALTH NEWS

Leaders from some of the nation’s top consumer and seniors advocacy groups today urged President Barack Obama not to weaken a key consumer provision of his signature health care overhaul law.

The provision requires health insurers and employers to use standardized, easy-to-understand information documents to describe health plan benefits and costs. These forms would explain how much each plan pays on average for three common medical conditions and include a glossary of insurance terms. [Continued here]

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By Susan Jaffe

POLITICO PRO 12/23/11 4:46 PM EST

When Congress gets back from the holidays, lawmakers are going to have to figure out how to find enough money to delay cuts in Medicare payments to doctors for a full year — but the patients have already started to pay for their share in their 2012 premiums.

Lost in the Capitol Hill debate is the fact that the federal government contributes only 75 percent of the cost of doctor visits and other outpatient services covered by Part B of the Medicare program. Under federal law, seniors chip in for the remaining 25 percent in the form of monthly premiums. The amount is based on estimated expenses for the coming year. And in calculating that share, Medicare officials anticipated that Congress would cancel the pay cut.

That means the patients will effectively pay part of the cost of a Sustainable Growth Rate “fix” before it’s been fixed…. more

Seniors already paying for full-year ‘doc fix’

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By Susan Jaffe

KAISER HEALTH NEWS in partnership wth National Public Radio

DEC 07, 2011

Federal officials are extending the Dec. 7 deadline for three days for some people who have had trouble enrolling in a Medicare prescription drug or private health plan because of the crush of last-minute sign-ups. …Seniors can only get extra time if they get on a call-back list. If they reach a live person, today’s deadline applies and they should be prepared to make a decision…. more

Medicare Offers Extra Enrollment Time For Seniors Who Call Today

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Officials Looking To Cut Federal Spending Eye Medigap Policies

By Susan Jaffe KAISER HEALTH NEWS in collaboration with Nov. 21, 2011

Margaret Fisher is among the millions of seniors with private, supplemental health insurance that takes care of most of the medical bills Medicare doesn’t cover. If she has a health crisis, she reasons, it won’t become a financial crisis, too.

But officials looking for ways to cut the federal deficit are suggesting that these Medigap policies help explain why the government’s Medicare bill is rising so fast. If these private policies were less generous, they figure, seniors might reduce their trips to the doctor or find cheaper care, which in turn would save the government money.Fisher, 86, a cancer survivor from Gaithersburg who has had two hip replacements, says that strategy could backfire… [Continued on Kaiser Health News and in The Washington Post]

CMS, Drugs, Medicare, Medicare Advantage, Medicare costs, Medigap

During open enrollment season, seniors can get help picking a Medicare drug plan

By Susan Jaffe | Kaiser Health News | November 11, 2011 | in collaboration with The Washington Post

Three weeks after suffering a heart attack, Bernie Hollander came to a recent meeting at Leisure World in Silver Spring with his wife, Rose, to learn about the Medicare drug plans being offered next year. “I’m a heart patient, I’m a diabetic – I have a lot of problems,” said Hollander, 81, who lives in the retirement community. But getting the expensive medications he needs isn’t one of them. e was at the meeting to get updated advice from Leta Blank, head of the Montgomery County Senior Health Insurance Assistance Program (SHIP).

Although drug coverage is optional, millions of Medicare beneficiaries enroll in a plan, and choosing the right one can be tricky. Seniors who want drug coverage must sort through dozens of policies covering different drugs from different pharmacies at different prices. Federal SHIP counselors can help untangle the details. [Continued on The Washington Post and Kaiser Health News, view video]

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By SUSAN JAFFE | POLITICO September 8, 2011

The American Hospital Association has a strategy for heading off any more Medicare payment cuts: Tell Congress to get the money from Medicare beneficiaries instead.

The association is urging its nearly 5,000 members to lobby Congress to raise the Medicare eligibility age from 65 to 67, in addition to other money-saving alternatives, according to spokeswoman Marie Watteau. MORE

Medicare eligibility age should go up, hospitals say

Drugs, Health IT, HHS, Medicare, Medicare costs

Doctors skittish about health technology despite promise of big federal bucks

By Susan Jaffe | Center for Public Integrity | July 7, 2011

The goal is to bring the last outposts of the nation’s health care system into the computer age, linking medical providers so that they can coordinate and improve patient care and — in the process—reduce unnecessary health care spending. But convincing everyone to use electronic health records has not been easy. …Neither reward nor punishment has

persuaded some small practice doctors — a troubling omen for the Obama administration, which believes that conversion of paper records to electronic form is a crucial step toward health care reform. [Continued]

Affordable Care Act

Consumers add their 2 cents to health law’s plan labels

By Susan Jaffe | June 23, 2011 | Kaiser Health News in partnership with

BUFFALO, N.Y. – At an office tucked next to Macy’s at the Boulevard Mall, Susan Kleimann pushes two sets of papers across a table to a woman in her 40s wearing a gray sweatshirt. “We aren’t testing you,” assures Kleimann, who runs a market research firm in Bethesda, Md. “We are testing health plan information.”

Kleimann explains that they will be comparing the two documents describing two hypothetical insurance plans. “What you tell us today will help us improve the information and be sure that consumers can easily understand what they read about different health plans,” she says. While a video camera captures every moment, the woman accepts the task with gusto. She says getting rid of some columns will make the form clearer and changing the blue ink to black will be easier on the eyes. But the last page is trouble. “This is really wordy,” she says. “I would have to put it down and go get a bowl of ice cream and go back to it later.”

Starting next March, all insurers and employers will have to make it easier for consumers faced with the ordeal of picking a health plan. Under the 2010 health law, they’ll have to provide health policy information that the average enrollee can understand and use to compare with other plans. The forms were developed by a group assembled by the National Assn. of Insurance Commissioners, and policymakers are getting feedback the same way advertisers learn the best way to sell orange juice: consumer-focus-group testing.

The woman in the gray sweatshirt is among eight people who received a $75 stipend to sit in a windowless room and spend 90 minutes reviewing the forms and answering questions. The one-on-one sessions, spread over two days last month along with an identical round in St. Louis, are sponsored by Consumers Union. Two representatives from the group, a Kaiser Health News reporter and other observers silently watch from a darkened hideaway room behind a one-way mirror; sound from the session is piped in through an audio system. [FULL story from Kaiser Health News] [ABRIDGED from Los Angeles Times]

Affordable Care Act

New labels will soon help consumers choose health plans

By Susan Jaffe, May 7, 2011, KAISER HEALTH NEWS in collaboration with The Chicago Tribune

Cars have sticker prices, ketchup bottles have nutrition-facts labels, and soon health plans will get coverage labels.

For the first time, consumers shopping for a health policy will be able to get a good idea of how much of the costs different plans will cover for three medical conditions: maternity care, treatment for diabetes and breast cancer. And because buying insurance is more complicated than buying a can of soup, the proposed insurance labels are two pages long. ….The new “coverage facts labels” are required under the health overhaul law, which directed the National Assn. of Insurance Commissioners to draft them. [MORE]

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By Susan Jaffe | April 26, 2011

KAISER HEALTH NEWS in collaboration with

Despite tough economic times, there are some things the government can’t give away.

Starting this year, seniors enrolled in Medicare no longer have to pay for more than a dozen tests and other services to help prevent or control cancer and other costly and debilitating diseases. These benefits, which also include an annual wellness exam, are part of the new federal health-care law.

But big crowds aren’t lining up for free mammograms or colonoscopies, although early data indicate that the free wellness checkup is luring patients. CONTINUED