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.
The wide-ranging order requires the Department of Health and Human Services to seek public comment on the drug price negotiation program, which effectively requires manufacturers to agree to lower prices for certain drugs, for potential changes in upcoming years.
The Centers for Medicare and Medicaid Services (CMS) will restrict federal funds for state-based programs that go toward certain priorities like rural broadband and student loan repayments. The department is looking to return to the “core mission of Medicaid” by rejecting, or not extending, federal matching fund requests for designated state health programs (DSHPs) and ...
Shares of U.S. health insurers jumped on Tuesday after a bigger-than-expected increase in the government’s reimbursement rates for Medicare Advantage plans in 2026 signaled some relief for a sector burdened with steep medical costs. Medicare-focused insurer Humana (HUM.N), opens new tab led gains with a 16% jump, while other health insurers including UnitedHealth Group (UNH.N), opens new tab, ...
California Gov. Gavin Newsom signed legislation Monday to close a $2.8 billion budget gap in the state’s Medicaid services and ensure coverage through June for 15 million people, including immigrants, who receive health care via the program. The legislation is part of the state’s solution to solve the $6.2 billion hole in the state’s Medicaid budget. It ...
The Centers for Medicare & Medicaid Services (CMS) finalized an increase of the average benchmark payments to Medicare Advantage (MA) plans by 5.06%, or $25 billion, on Monday. It is nearly a three-percentage-point increase over the advance notice proposed in the waning days of the Biden administration and will be seen as favorable to payers. ...
The Centers for Medicare & Medicaid Services (CMS) finalized a Medicare Advantage (MA) rule proposed by the Biden administration but is choosing to leave out the rule’s flashiest policy. As outlined by the CMS, the Trump administration’s final rule will not include three proposals included in the initial proposal, including the plan to cover anti-obesity ...
PBMs, which administer prescription drug benefits for health insurance plans, employers, and other organizations including governments, are driving up prescription drug costs, putting small pharmacies out of business, and interfering with doctor and patient relationships, says Sen. Rochelle Nguyen
The Trump administration and Republicans broadly have said they can cut Medicaid’s budget without hurting patient care by finding efficiencies. Colorado Rep. Diana DeGette, the top Democrat on a key health care panel, says that’s not so. “We just simply don’t have that much money,” DeGette said at POLITICO’s Health Care Summit Wednesday. President Donald ...
Bipartisan lawmakers have introduced a bill that aims to more closely align Medicare insurers’ prior authorization denials with medical need, as determined by board-certified specialist physicians.
Nonprofit hospitals’ 2024 financial performances are beating the prior year’s tough numbers, though even the stronger organizations remain “well below pre-pandemic levels,” Fitch Ratings said. In a Thursday brief describing the financial profiles of its rated nonprofit hospitals, the agency attributed the year-to-year improvements to stronger revenues and volumes as well as slightly mitigated, but ...