Feds Rein In Use of Predictive Software That Limits Care for Medicare Advantage Patients

Judith Sullivan was recovering from major surgery at a Connecticut nursing home in March when she got surprising news from her Medicare Advantage plan: It would no longer pay for her care because she was well enough to go home.

At the time, she could not walk more than a few feet, even with assistance — let alone manage the stairs to her front door, she said. She still needed help using a colostomy bag following major surgery.

“How could they make a decision like that without ever coming and seeing me?” said Sullivan, 76. “I still can’t walk without

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Nearly 1.7 million Texans lose Medicaid as state nears end of “unwinding”

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Nearly 1.7 million Texans have lost their health insurance — the largest number of people any state has removed — in the months since Texas began peeling people off Medicaid as part of the post-pandemic “unwinding.” Around 65% of these removals occur because of procedural reasons, according to the state.

Texas’ Health and Human Services Commission has neared the end of a chaotic and overburdened process to remove people from state Medicaid insurance who became ineligible during the

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Judge argues lawsuit against Central Health

Friday, May 10, 2024 by Jo Clifton

After hearing about two hours of arguments on Thursday, Travis County District Judge Amy Clark Meachum told attorneys for Travis County’s health care district and the three taxpayers who are suing Central Health, over its use of $35 million per year in taxpayer money that she would take their arguments under advice. She directed both sides to prepare orders for her to sign.

Plaintiffs Rebecca Birch, Richard Franklin III and Esther Govea filed suit in 2017, claiming that Central Health is not authorized to pay the University of Texas’ Dell Medical School any

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