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Yahoo
an hour ago
- Health
- Yahoo
Dr. Oz on the future of US healthcare: 'There is a new sheriff in town'
In an exclusive interview on Yahoo Finance's Decoding Retirement podcast, Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services (CMS), discussed the financial and operational challenges facing the US healthcare system. Ultimately responsible for the healthcare of 66 million Medicare beneficiaries, 78 million people enrolled in Medicaid and the Children's Health Insurance Program (CHIP), and millions more in Affordable Care Act health plans, Oz weighed in on issues ranging from new Medicaid work requirements to Medicare Advantage fraud. Medicaid work requirements The Congressional Budget Office (CBO) estimates that the One Big Beautiful Bill Act (OBBBA) could reduce federal Medicaid spending by $793 billion over the next decade and lead to 10.9 million fewer enrollees by 2034. This is partially attributed to the Medicaid work requirements the OBBA will make states enforce for certain adult enrollees by Jan. 1, 2027, which generally involves 80 hours per month of work, community service, education, or work programs. The CBO estimates the requirement will decrease coverage by 5.2 million enrollees by 2034. Concerns about red tape are not hypothetical: In Georgia, where work requirements are already in place, reports show otherwise eligible workers are losing coverage simply because of paperwork hurdles. However, Oz said that technology and digital solutions could help beneficiaries comply with the rules without losing coverage. 'We've already launched two pilots in Louisiana and Arizona with good results so far,' Oz said. The new digital process, he explained, uses a smartphone app to verify work automatically through payroll providers. "The people running it are the same folks who fixed the passport system in America,' he said. 'Ninety-one percent of people on Medicaid have smartphones. You tap on the smartphone within the app where you're working. Let's say you're an Uber driver, it knows that ADP does your payroll, and so it asks you permission, can I contact ... ADP and ask them about your hours? You say yes and boom ... the entire process is less than seven minutes." Oz, however, stopped short of addressing some key questions, for example, how many people might lose coverage under the current system, or whether administrative barriers will unfairly affect millions before the new technology is fully in place. Medicare Advantage and 'upcoding' Oz weighed in on the controversy swirling around Medicare Part C, better known as Medicare Advantage. About 33 million people are enrolled in these private plans, offered by companies such as UnitedHealth Group (UNH) and CVS Health (CVS). Medicare Advantage allows enrollees to receive Part A (hospital), Part B (medical), and, when bundled, Part D (prescription drug) coverage in one plan. The program has been under a harsh spotlight. Earlier this month, UnitedHealth confirmed it is under federal investigation. And a Wall Street Journal story detailed how some Medicare Advantage providers allegedly exploited the system through questionable or outright fraudulent billing practices. 'The whole point of launching Medicare Advantage was to give seniors options," Oz said. "But in the middle of all this, if it turns out that Medicare Advantage is costing us a lot more than fee-for-service, you're violating the whole premise.' The big problem is 'upcoding," the practice of inflating the severity of patients' conditions to trigger higher government payments. 'In Medicare Advantage, I do think that there's been an ability for the private companies to game the coding system,' Oz said. 'Instead of just saying, 'I got what I got, I'm going to take care of them and be honest about how sick they are,' they expertly devised tactics to upcode to pretend the patients were sicker than they really were. That got them more money.' Oz said CMS is now taking aggressive steps to recover funds and send a message: 'We have a process called RADV that allows us to go back to the late teens and, for the first time, audit Medicare Advantage companies,' he said. 'Based on what we find, we're going to pull money back from them. We expect it will be billions and billions of dollars. But more importantly, we're sending a message to the industry: Listen, I want you to succeed. I want you to thrive, but not at the expense of the American taxpayer.' Concern about Medicare's financial future According to the 2025 OASDI Trustees Report, Medicare Part B premiums are expected to rise 11.6% in 2026 to $206.50 a month — the steepest single-year increase in nearly a decade. At the same time, the Medicare Hospital Insurance Trust Fund, which finances Part A, is projected to run dry in 2033. If Congress doesn't intervene, that insolvency would trigger an automatic 11% cut in covered hospital services. Oz called the looming Part B increase a 'major concern,' citing the surge in prescription drug prices as the primary culprit. 'But there are other things,' Oz said, 'that are in Part B as well that we believe we have control over and we could get to be more efficient.' Rather than promising immediate regulatory fixes, Oz said his agency should work directly with industry. 'A lot of this is hearing the stakeholders and then pushing back on what you've heard and then letting them actually come up with some ideas themselves,' he said. 'We've gone back to all of them and said, we need better answers. What you're doing now is making you a lot of money, and you can do that for another year or two — and then the bottom's going to fall out.' 'The… Trustees Report predicts that [Part A] is bankrupt in 2033,' Oz added. 'That's three years shorter than we thought a month ago. And in their worst-case scenario, it goes bankrupt in [2029].' For context, Medicare Part A is primarily funded through a dedicated payroll tax under the Federal Insurance Contributions Act, or FICA. The total Medicare tax rate is 2.9% of wages — typically split evenly between employee and employer. That means 1.45% is withheld from your paycheck, and your employer contributes the other 1.45% on your behalf. Navigating Medicare open enrollment As Medicare's annual open enrollment period approaches — beginning Oct. 15 for 2026 coverage — millions of beneficiaries will face one of the biggest financial decisions of the year: whether to stick with their current plan or make a change. Most Medicare beneficiaries never switch plans, even though premiums, provider networks, and drug formularies can change from year to year. So how might retirees navigate this? 'We have to give people information,' Oz said. 'At the same point, I don't want people to panic and jump to changes." His advice is simple: Do your homework, but don't feel pressured to change plans unless you have a clear reason. One big resource: 1-800-MEDICARE. 'It's easy to remember, and it's got a ton of information,' he said. 'Especially during open enrollment, I strongly urge you to do a little work.' Hospice scams Healthcare scams are on the rise — and Medicare beneficiaries are among the top targets. The CMS recently sounded the alarm in a blog post and video featuring Oz, warning older Americans to be on guard for this disturbing trend. 'Beware of scammers, sometimes posing as salespeople, offering 'free' services or gifts,' the CMS blog warned. 'They may be trying to trick you into signing up for hospice care without your knowledge.' 'This is a reprehensible activity,' Oz said. 'It's run by criminal syndicates — not small-time operators. They take advantage of people at their most vulnerable time.' Hospice fraud is insidious because it targets people making some of the most difficult decisions of their lives. Oz said, 'We are hearing horror stories about people who thought they were entering legitimate hospice and there's nothing there for them. And even worse — because you're not really sick — people are on these hospice programs for years. We're going after them in a big way.' 'There is a new sheriff in town' Oz promised a tougher stance against healthcare fraud, both foreign and domestic. 'We already have actions in several states,' he said. 'The Department of Justice is pursuing a lot of these leads. We will leave no stone unturned. There is a new sheriff in town. I promise you, if you're cheating the American people, we will come after you. And if you're doing it to hurt folks who are most vulnerable — we'll be doubly vigilant.' Beyond enforcement, Oz emphasized that better technology and patient identification are key to preventing fraud before it happens. 'You're talking about an agency with a $1.7 trillion budget,' Oz said. 'One policy memo can affect [tens of millions of Americans.] We have to get it right.' One key: distilling the complexity of the system into actionable information for both the public and his team. 'The goal is the same as it was" on his TV show, Oz said. "Explain it so people understand it and can act on it,' he said. 'If we simplify the rules, give people clear guidance, and enforce the protections already in place, we can change outcomes for millions of Americans." - Got questions about retirement? Email Robert Powell at yfpodcast@ and we'll do our best to answer it in a future episode of Decoding Retirement. Each Tuesday Powell, a retirement expert and financial educator, gives you the tools to plan for your future. You can find more episodes on our video hub or watch on your preferred streaming service. Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
BBC News
9 hours ago
- BBC News
Leeds shop raids uncover illegal goods valued at £83,000
Illegal goods valued at about £83,000 have been seized in a series of police and trading standards raids on shops in a Leeds from West Yorkshire Police and West Yorkshire Trading Standards seized 3,000 boxes of cigarettes as part of the operation in Armley last of tobacco pouches and more than 600 oversized vapes were found as well as single-use vapes and stolen Steve Ellis, from West Yorkshire Police, said: "We know that the sale of illegal tobacco and vapes is often linked to anti-social behaviour and crime and it is especially concerning when these items are suspected of being sold to children." Sgt Ellis said money from selling illicit goods can be used to fund serious and organised crime."It is vital we continue to do all we can to take them off the streets," he this month a Leeds city centre shop was given a six-week closure order after illegal cigarettes and vapes valued at £5,000 were illicit tobacco trade involves a range of tobacco products being sold illegally, often to underage users, without paying taxes, a HM Revenue & Customs spokesperson said."It provides a cheap and unregulated supply of tobacco to those who might otherwise be deterred by cost," they part of the police and trading standards operation, which aims to improve safety in town centres, a 43-year-old woman from Bramley was given a two-year Criminal Behaviour Order (CBO) on 14 July which prevents her from entering six shops around Briscoe, of Poplar Way, was convicted of theft from a shop on 18 June and will no longer be able to enter the following stores:Savers on Town Street, ArmleyAldi on Stanningley RoadTesco in Bramley Shopping CentreSainsburys on Ring RoadOne Stop on WhingateHome Bargains on Stanningley Road
Times of Oman
a day ago
- Business
- Times of Oman
Oman's central bank issues treasury bills worth OMR22mn
Muscat: Oman's central bank raised OMR22 million by way of allotting treasury bills on Monday. The value of the treasury bills are for a maturity period of 91 days. The average accepted price reached OMR98.933 for every OMR100, and the minimum accepted price arrived at OMR98.930 per OMR100. The average discount rate and the average yield reached 4.27900% and 4.32514%, respectively. Treasury Bills are short-term highly secured financial instruments issued by the Ministry of Finance, and they provide licensed commercial banks the opportunity to invest their surplus funds. The Central Bank of Oman (CBO) acts as the Issue Manager and provides theadded advantage of ready liquidity through discounting and repurchase facilities (Repo). It may be noted that the interest rate on the Repo operations with CBO is 5.00% while the discount rate on the Treasury Bills Discounting Facility with CBO is 5.50%. Furthermore, Treasury Bills promote the local money market by creating a benchmark yield curve for short-term interest rates. Additionally, the Government may also resort to this instrument whenever felt necessary for financing its recurrent expenditures.
Miami Herald
a day ago
- Health
- Miami Herald
Fact check: Are 5 million nondisabled Medicaid recipients watching TV all day? That's unsupported
"Almost 5 million able-bodied Medicaid recipients 'simply choose not to work' and 'spend six hours a day socializing and watching television.'" Scott Jennings on "CNN NewsNight with Abby Phillip" on July 1 ____ Republicans defended the GOP megabill's Medicaid changes as targeting a group of people they believe shouldn't qualify: people who can work but instead choose to stay home and chill. Several Republican politicians and pundits, including CNN senior political commentator Scott Jennings, pegged that group's size at about 5 million people. "There are like almost 5 million able-bodied people on Medicaid who simply choose not to work," Jennings said July 1 on "CNN NewsNight with Abby Phillip." "They spend six hours a day socializing and watching television. And if you can't get off grandma's couch and work, I don't want to pay for your welfare." Centers for Medicare & Medicaid Services Administrator Mehmet Oz picked up on some of these points during a July 14 appearance on Fox News. "When the program was created 60 years ago, it never dawned on anyone that you would take able-bodied individuals who could work and put them on Medicaid. Today the average able-bodied person on Medicaid who doesn't work, they watch 6.1 hours of television or just hang out," Oz said. Medicaid is a federal-state health insurance program that covers medical care for lower-income people. Jennings cited two pieces of data: an estimate of how many fewer people would have coverage because of the work requirement and an analysis of how nonworking Medicaid recipients spend their time. But he made assumptions that the data doesn't support. Jennings Misrepresents CBO Estimate The 4.8 million figure stems from a June 24 Congressional Budget Office analysis of a preliminary House version of the massive tax and spending package. The office, Congress' nonpartisan research arm, projected that provisions of the bill would cause 7.8 million fewer people to have health coverage by 2034. They would include 4.8 million people previously eligible for Medicaid described as "able-bodied" adults 19 to 64 years old who have no dependents and who "do not meet the community engagement requirement" of doing "work-related activities" at least 80 hours a month. Apart from working, doing community service and attending school also fulfill the community engagement requirement. Jennings paired that statistic with a separate analysis of how nondisabled adult Medicaid recipients without dependent children spend their time. But the CBO estimate was a projection - it doesn't represent the current number of nondisabled Medicaid recipients, nor does it say 4.8 million people in this group "choose not to work." The figure represented how many fewer people would have coverage because of the bill's community engagement requirement. "The challenge with Jennings' comments - and they've been echoed elsewhere by elected Republicans - is that CBO never said that 4.8 million people were out of compliance with the proposed work requirements; they said that 4.8 million people would lose coverage because of the work requirements," said Adrianna McIntyre, an assistant professor of health policy and politics at the Harvard T.H. Chan School of Public Health. Among the Medicaid expansion population, the law requires most adults without dependent children and parents of children older than 13 to work or participate in other qualifying activities 80 hours every month. States will need to verify that applicants met the work requirement for one to three months before they applied. States will also be required to verify that existing enrollees met the work requirement for at least a month between eligibility determinations, which will be required at least twice a year. Research into Medicaid work requirements imposed at the state level has shown that people found it difficult to fulfill them and submit documentation, contributing to coverage losses. In Arkansas, which added a work requirement to Medicaid in 2018, a study based on nearly 6,000 respondents found that about 95% of the target population were already working or qualified for an exemption, but a third of them did not hear about the work requirements. As a result, nearly 17,000 Medicaid recipients subject to work requirements lost coverage. KFF found that adults ages 50 to 64 are more at risk of losing Medicaid coverage because of the new work requirements. More than 1 in 10 in that age group said they had retired, and among them, 28% reported being disabled, said KFF, a health information nonprofit that includes KFF Health News. Benjamin Sommers, a health care economics professor at the Harvard Chan school, said many of the 4.8 million "able-bodied" people in the CBO estimate "will actually be engaged in the activities they are supposed to be doing, and lose coverage because they are not able to navigate the reporting requirements with the state and lose coverage from red tape." When Recipients Don't Work, It's Rarely From Lack of Interest There is no universal definition for "able-bodied"; disability can be assessed in different ways. But other studies offer much smaller estimates than 4.8 million Medicaid recipients without dependents who can work but choose not to. Millions of working-age, nondisabled adults joined the Medicaid ranks in states that expanded eligibility under the Affordable Care Act. There were about 34 million working-age nondisabled Medicaid enrollees in 2024, according to the CBO, 15 million of whom enrolled through the ACA. A KFF analysis found a smaller figure of 26 million Medicaid-covered adults, ages 19 to 64, who don't receive Supplemental Security Income, Social Security Disability Insurance, or Medicare benefits. Among this group, KFF estimated, 64% were working either full time or part time. The reasons the rest were not working included caregiving (12%); illness or disability (10%); retirement, inability to find work, or other reason (8%); and school attendance (7%). Few people cited lack of interest in working as the reason for their unemployment. An Urban Institute study found 2% of Medicaid expansion enrollees without dependents who neither worked nor attended school - or 300,000 people out of a projected 15 million subject to work requirements - cited a lack of interest in working as the reason they were unemployed. This was consistent with the Brookings Institution's June 5 analysis that found that, of 4.3 million adult enrollees who worked fewer than 80 hours a month and did not have any activity limitations or illnesses, about 300,000 reported that they "did not work because they did not want to." Mostly Women, Mostly With a High School Degree or Less When Republicanshave described nondisabled adult Medicaid recipients, they have often portrayed them as men in their 30s "playing video games" in their parents' basement or who "smoke weed all day." Research paints a different picture. Jane Tavares and Marc Cohen, of the University of Massachusetts-Boston Gerontology Department, researched Medicaid recipients who are not disabled or working, have no dependent children under 18, and are not in school. They cited 2023 census data from the American Community Survey. They found: --The average age of this population is 41, and 26% are older than 50. --Almost 80% are female. --Most, 80%, have a high school education or less. --Their median individual income is $0, and their median household income is $44,800. --About 56% worked in the past five years, and 23% worked in the prior year. About 30% are looking or available for work. "They are not healthy young adults just hanging out," the authors, along with health law experts Sara Rosenbaum and Alison Barkoff, wrote April 30. "It's clear based on their prior work history and family size/income that they are exceptionally poor and have likely left the workforce to care for adult children or older adults," Tavares told PolitiFact. "Even if these individuals could work, they would have very few job opportunities and it would come at the cost of the people they are providing care for." AEI Study Not Definitively Linked to CBO Estimate On the social platform X, Jennings posted the CBO letter and a May 29 analysis by the American Enterprise Institute, a conservative think tank, about "how nondisabled Medicaid recipients without children spend their time." PolitiFact contacted CNN to reach Jennings but did not receive a reply. The author of that study, American Enterprise Institute senior fellow Kevin Corinth, analyzed survey data and found that Medicaid recipients who do not report working spend on average 6.1 hours a day "on all socializing, relaxing and leisure activities (including television and video games)." But it's uncertain whether the people in the survey population he analyzed overlap with the people included in the CBO analysis, said Jennifer Tolbert, deputy director of KFF's Program on Medicaid and the Uninsured. Corinth told PolitiFact "it is difficult to say" how the population he analyzed differs from the CBO's. Tavares, Cohen, Rosenbaum, and Barkoff said Corinth's dataset defined disability narrowly, leading to a "serious underestimation of disability" among the population of Medicaid recipients he looked into. It focused on Medicaid recipients who receive Supplemental Security Income or have a health condition that prevents them from working. The researchers said this approach is too narrow because the SSI program accounts for only those "most deeply impoverished adults with severe disabilities." The group gave a hypothetical example of a 54-year-old woman with a serious heart condition who can work only a few hours a week. She may not be considered disabled under the SSI program, but she may be limited in the work she can do and may need time to rest. "Using her 'leisure time' to justify a work requirement grossly misrepresents her reality," the group wrote. Corinth's analysis also shows that nonworking Medicaid recipients spend less time socializing, relaxing, or engaged in leisure activities than nonworking people who aren't covered by Medicaid. Nonworking Medicaid recipients also spend more time looking for work and doing housework and errands, it found. Our Ruling Jennings said almost 5 million nondisabled Medicaid recipients "simply choose not to work" and "spend six hours a day socializing and watching television." The 5 million figure stems from a CBO projection that 4.8 million people would go without coverage by 2034 as a result of not fulfilling the community engagement requirements. It is not descriptive of current enrollees and does not specify that these people choose not to work. Jennings cited an American Enterprise Institute analysis on how nondisabled Medicaid recipients with no dependents spend their time, but it is uncertain if the population in that analysis overlaps with that in the CBO estimate. Current snapshots of the population Jennings described produce a smaller number. A survey by the Urban Institute found that 2% of Medicaid expansion enrollees without dependents who were neither working nor attending school - about 300,000 people - cited a lack of interest in working. Other research has found reasons this group doesn't work include caregiving, illness or disability, retirement, and inability to find work. Studies of nonworking Medicaid recipients have found the majority are women and have a high school education or less. Their average age is 41, and more than half have a work history in the past five years. We rate Jennings' statement False. ____ Copyright (C) 2025, Tribune Content Agency, LLC. Portions copyrighted by the respective providers.
Fibre2Fashion
7 days ago
- Business
- Fibre2Fashion
Trump's OBBBA to add $3.39 trn to primary debt from 2025 to 2034: CBO
The One Big Beautiful Bill Act (OBBBA), signed into law on July 4, would add $3.39 trillion to the US primary debt between 2025 and 2034, according to a recent report by the non-partisan Congressional Budget Office (CBO). The latest CBO estimate is higher than its estimate of $3.25 trillion made at the end of June. The increase is estimated to result from a decrease in direct spending of $1.1 trillion and a decrease in revenues of $4.5 trillion, CBO said. The One Big Beautiful Bill Act would add $3.39 trillion to the US primary debt between 2025 and 2034, a report by the Congressional Budget Office said. The latest CBO estimate is higher than its estimate of $3.25 trillion made at the end of June. With interest, the tax and budget act would increase borrowing by an estimated $4.1 trillion, according to the Committee for a Responsible Federal Budget. With interest, the tax and budget act would increase borrowing by an estimated $4.1 trillion, according to Maya MacGuineas, president of the Committee for a Responsible Federal Budget. "It's still hard to believe that policymakers just added $4 trillion to the debt. Many supporters of this law have spent months or years appropriately fuming about our unsustainable fiscal situation. But when they actually had an opportunity to fix it, they instead made it $4 trillion worse," said MacGuineas in a statement. 'Modelers from across the ideological spectrum universally agree that any sustained economic benefits are likely to be modest, or negative, and not one serious estimate claims this bill will improve our financial situation,' she said. As of mid-2025, the US national debt stands at over $36.2 trillion, and the debt-to-gross domestic product ratio has exceeded its peak during World War II. President Donald Trump signed the bill into law after weeks of debate among congressional Republicans. The bill passed the Senate 51-50 before it passed the House of Representatives 218-214. Democrats have universally criticised the bill. Fibre2Fashion News Desk (DS)
