Month: August 2024
The Fifth Circuit Court's ruling, which was filed late last week, confirms a February 2023 decision from the court in the Eastern District of Texas, vacating arbitration methodology set by the Centers for Medicare & Medicaid Services (CMS).
The Centers for Medicare & Medicaid Services (CMS) is creating a voluntary demonstration program to support changes to Medicare Part D under the Inflation Reduction Act (IRA). The agency also finalized bid information for contract year 2025, with a base beneficiary premium increase of $2.08 for people with Part D. The IRA is designed to ...
Why OIG Did This Audit California pays managed care organizations to make services available to eligible Medicaid enrollees in return for a monthly fixed payment (capitation payment) for each enrollee. Previous OIG audits found that State Medicaid agencies made capitation payments on behalf of enrollees who were residing and enrolled in Medicaid in another State. ...
Health Savings Accounts (HSAs) are a valuable tool for eligible individuals to save tax-free dollars for health care expenses, with the added benefit of accumulating tax-free interest over time. Introduced in 2003 and available to individuals starting in 2004, HSAs have become an integral part of health care planning and financial savings. While many health ...
Heat Map: Share of Residents Who Are Uninsured, 2022 Texas is home to the country’s largest share of Americans under 65 without health insurance, according to new Census Bureau data, with 18.8% of residents uninsured as of 2022. Why it matters: That’s a big improvement over 2006, when 27.6% of Texans were uninsured — but still nearly ...
Consumers who try to buy popular weight loss drugs online without a prescription risk being scammed or receiving unsafe products, a new study shows. About 42% of online pharmacies that sell semaglutide, the active ingredient in Novo Nordisk’s anti-obesity drug Wegovy, are illegal, operating without a valid license and selling medications without prescriptions, according to a ...
One possible symptom of hospital consolidation, exhaustion or confusion: Fewer have star ratings from the Centers for Medicare and Medicaid Services. The number of hospitals that sent CMS enough of the right data to be graded on the agency’s five-star quality rating system fell to 2,847 this year, down 7.4% from the number that earned ...
Nearly half of Americans with health insurance said they received a recent medical bill or a charge that “should have been free or covered by their insurance,” according to a survey released Thursday. The survey, from the Commonwealth Fund in New York City, found 45% of working-age consumers last year were erroneously billed, however, fewer than half ...
The Biden administration has finalized proposed payment rates for inpatient services in the coming year, and they’re not likely to be welcomed by hospitals. Initially, the Centers for Medicare & Medicaid Services (CMS) proposed a 2.6% payment increase for 2025, which providers decried as inadequate. In the final Inpatient Prospective Payment System (IPPS) rule, that ...
Cigna CEO David Cordani mounted a defense of pharmacy benefit managers during the company’s earnings call on Thursday morning as regulators and critics turn up the heat on the industry. Cigna owns Express Scripts, which along with CVS’ Caremark and UnitedHealth Group’s Optum Rx, dominate the PBM space. Cordani said that pharmacological innovation is a ...