Medicare Medicaid Category

Medicare & Medicaid

News articles in this section include actions by federal regulators like the CMS and HHS, as well as information on Medicare and state Medicaid coverage and benefits.

Bill To Avert Government Shutdown Stalls In Senate As Democrats Demand Talks

The House passed a Republican-backed measure, largely along party lines, that would push the shutdown deadline to Nov. 21. But then the Senate rejected a Democrat-led proposal that would keep the government open through Oct. 31, as well as implement several Democratic priorities.

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States Are Cutting Medicaid Provider Payments Long Before Trump Cuts Hit

Every day for nearly 18 years, Alessandra Fabrello has been a medical caregiver for her son, on top of being his mom. “It is almost impossible to explain what it takes to keep a child alive who should be dead,” said Fabrello, whose son, Ysadore Maklakoff, experienced a rare brain condition called acute necrotizing encephalopathy ...

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Medicare Part D Notices: What Brokers Need to Know for 2025 and 2026

By October 14, 2025, employers with plans providing prescription drug coverage must distribute Medicare Part D creditable coverage notices. These notices help Medicare-eligible individuals – employees and dependent(s), including those eligible due to disability or End-Stage Renal Disease (ESRD) – decide whether to keep employer coverage or enroll in Part D for 2026. Here’s the good ...

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Gutting Medi-Cal’s Weight Loss Drug Coverage Will Cost California More In The Long Run

Under the new budget signed by Gov. Gavin Newsom, Medi-Cal — the state’s Medicaid program — would no longer cover weight loss drugs, such as Wegovy and Zepbound, unless they’re prescribed to treat diabetes. The measure is intended to promote fiscal responsibility.

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New Medicare Pilot Under Trump Would Require Prior Approval

Prior authorization is similar to how private insurers operate, often resulting in a delay or denial of treatments

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Medicare ACOs Saved $2.4B In 2024, Setting A New Record For The Program

Accountable care organizations saved Medicare $2.4 billion last year, according to new federal data. The Centers for Medicare & Medicaid Services released (PDF) the latest results from the Medicare Shared Savings Program, which shows that 75% of the 476 participating ACOs earned $4.1 billion in performance payments. These organizations represent 80% of the 10.3 million beneficiaries assigned ...

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HHS To Form Outside Committee On Reshaping Medicare, Medicaid

The Department of Health and Human Services (HHS) will seek external experts for a new committee tasked with providing strategic guidance on the care provided by government insurance programs. The HHS announced Thursday that the Healthcare Advisory Committee will offer recommendations to Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet ...

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Judge Vacates Medicare Advantage Marketing Rule Provisions

A district court in Texas has ruled against the Department of Health and Human Services, deciding to vacate several provisions imposed last year impacting how Medicare Advantage (MA) plans market products. The Centers for Medicare & Medicaid Services (CMS) finalized a rule in April 2024 that fixed broker and agent compensation and raised the pay ...

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CBO: Reconciliation Package Could Lead To $500B In Medicare Cuts Over Next Decade

A new analysis from the Congressional Budget Office (CBO) warns that Republicans’ massive tax bill could lead to hundreds of billions in cuts to Medicare over the next 10 years. CBO analysts, in a letter (PDF) to key Democratic senators Friday, dug into the potential impact the One Big Beautiful Bill Act could have on federal programs ...

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Bay Area County Could Raise Taxes To Offset Trump Medicaid Cuts

In response to recent federal legislation that cuts billions of dollars to Medicaid, Santa Clara County supervisors on Thursday unanimously voted to add a ballot measure to November’s special election that would increase local sales tax by five-eighths of a cent (0.625%) for five years to try to backfill some of the projected lost federal ...

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