���ϳԹ���

Kaiser Health News: Another Problem On The Health Horizon: Medicare Is Running Out Of Money 

Everyone involved even tangentially in health care today is completely consumed by the coronavirus pandemic, as they should be. But the pandemic is accelerating a problem that used to be front and center in health circles: the impending insolvency of Medicare. With record numbers of Americans out of work, fewer payroll taxes are rolling in to fund Medicare spending, the numbers of beneficiaries are rising, and Congress dipped into Medicare’s reserves to help fund the COVID-19 relief efforts this spring. (Rovner, 7/22)

Clover Health, a venture capital-backed startup that sells health insurance to seniors, is planning a big expansion into more states and counties next year on the heels of rapid membership growth in 2019. San Francisco-based Clover said it intends to sell Medicare Advantage plans in 69 additional counties in its existing markets of Arizona, Georgia, New Jersey, Pennsylvania, South Carolina, Tennessee and Texas. It will also enter five counties in Mississippi, a new market. Currently, Clover sells Advantage plans in 34 counties across seven states. (Livingston, 7/21)

Georgia’s faulty oversight of private Medicaid management contractors has left the state’s Medicaid program vulnerable to overpaying for health care and to fraud, a state auditor’s report has found. Over seven years from 2013 to 2019, a total of $41 million in claims the contractors paid out for Medicaid “were not subject to adequate oversight and claims review,” the report says, and some questionable claims were forwarded to the state for review but left to languish for years. (Hart, 7/21)