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.

Biden Administration Expects To Win Fight Over Medicare Drug Negotiations

White House domestic policy adviser Neera Tanden said Sunday that she’s convinced that the Inflation Reduction Act’s Medicare drug price negotiation program will be upheld in court. Speaking on “The Katie Phang Show” on MSNBC, Tanden said, “There is nothing in the Constitution that stops Medicare from negotiating drug prices. We really, we feel very ...

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Humana Sues Feds Over Medicare Advantage Risk Adjustment Changes

Humana has filed suit against the feds, saying the Biden administration’s bid to claw back overpayments in Medicare Advantage (MA) is built on “shifting justifications and erroneous legal reasoning.” Earlier this year, the Centers for Medicare & Medicaid Services (CMS) finalized a hotly anticipated rule that would overhaul risk adjustment data validation (RADV) audits, which determine whether ...

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Biden Administration Unveils First 10 Drugs Subject To Medicare Price Negotiations

The Biden administration on Tuesday unveiled the first 10 prescription drugs that will be subject to price negotiations between manufacturers and Medicare, kicking off a controversial process that aims to make costly medications more affordable for older Americans.

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Will Drug Price Negotiations Work? Here’s What You Need To Know.

Many steps remain before older adults see the benefit of the Centers for Medicare and Medicaid Services’ upcoming talks with drugmakers.

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Biden Urged To Get Tough As Millions Lose Medicaid

Millions of people are being pushed off state Medicaid rolls as the U.S. dismantles one of the last major Covid-era safety nets, and congressional Democrats and health advocates want the Biden administration to do more to ensure people are protected. Nationwide, nearly 5.5 million people have been purged from state Medicaid rolls across 45 states and the ...

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Tribal Health Workers Aren’t Paid Like Their Peers. See Why Nevada Changed That.

Most state Medicaid programs don’t recognize or pay for services offered by health workers, such as Noneo, who work on tribal lands. That’s despite their work being essentially the same as that of “community health workers” in nontribal communities, a classification many state Medicaid programs cover.

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Feds Raise Concerns About Long Call Center Wait Times As Millions Dropped From Medicaid

As millions of Medicaid recipients face the potential loss of health coverage for the first time since the coronavirus pandemic, state call centers are getting inundated with questions from people needing help. In some cases, federal officials say, it’s taking too long to get answers.

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Feds Say Hospitals That Redistribute Medicaid Money Violate Law

The Biden administration wants to crack down on private arrangements among some hospitals to reimburse themselves for taxes that help fund coverage for low-income people. It contends the practice violates federal law. Federal regulators say these arrangements “appear designed to” redirect Medicaid dollars away from facilities that treat the poorest patients to those that “provide ...

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Costliest Medicare Drugs More Than Tripled In Price Since Entering Market: Report

The 25 drugs that accounted for the highest Medicare Part D spending in 2021 more than tripled in price since they first entered the market, according to a new report from AARP.

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DOJ Blasts Industry Attempt To Delay Medicare Drug Price Negotiations

The Department of Justice (DOJ) lambasted the Chamber of Commerce’s request for an injunction to block the Medicare drug price negotiation program, arguing in court filings that the organization had no standing to file the lawsuit and that pausing the program would harm the public. The rebuttal comes weeks before the federal government is expected ...

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