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.
This year kicked off with a new administration heralding big policy changes in areas that affect employee health & welfare benefits. This year’s Roundup is packed with the latest legislative and regulatory developments that matter most to health benefit plan sponsors and service providers. From significant consumer-directed health legislative changes in telehealth and health savings ...
The federal government has announced the results of the latest round of Medicare drug price negotiations: 15 lower drug prices for Medicare to go into effect in 2027. Medicare will get a 71% discount on Ozempic, Wegovy and Rybelsus, blockbuster drugs for obesity and Type 2 diabetes that have current list prices of around a thousand dollars ...
The Trump administration is proposing significant changes to the metrics used to the calculate the Medicare Advantage star ratings. As part of the Contract Year 2027 MA and Part D proposed rule, the Centers for Medicare & Medicaid Services has pitched that the Excellent Health Outcomes for All award, known previously as the Health Equity ...
Medicare program managers could make life a little easier in 2027 for employers that offer health savings accounts, health reimbursement arrangements or individual coverage health reimbursement arrangement plans. Officials want to exempt the sponsors from having to tell health plan participants who are ages 65 or older whether they have solid prescription drug coverage. The ...
Eliza Brader worries she soon will need to prove she’s working to continue receiving Medicaid health coverage. She doesn’t think she should have to. The 27-year-old resident of Bloomington, Indiana, has a pacemaker and a painful joint disease. She also has fused vertebrae in her neck from a spinal injury, preventing her from turning her ...
Breakthroughs in weight-loss medicine are presenting state Medicaid officials with what looks like a sure bet: Spend big now to cover the drugs and reap savings when diabetes, heart disease and cancer rates drop. States are hesitating to take it. The few states that have decided to cover drugs like Ozempic and Wegovy to help ...
Healthcare politics and investing might as well be living in alternate universes. President Trump and some Republicans have been describing Obamacare as a gravy train for insurers. Trump’s latest broadside slammed “big, fat, rich insurance companies who have made trillions,” and he urged Congress to send healthcare subsidies directly to patients instead. Wall Street sees ...
The stopgap spending bill signed Nov. 12 by President Donald Trump halts a looming $536 billion Medicare cut and temporarily extends several key health programs, avoiding deeper disruptions from the now-ended government shutdown. The legislation keeps most federal agencies funded through Jan. 30 and fully funds the Department of Agriculture, the FDA and the VA ...
Medicare beneficiaries are set to see their Part B premiums rise significantly next year, according to an announcement from the Trump administration. The Centers for Medicare & Medicaid Services (CMS) revealed late Friday that total monthly premiums for Part B will be $202.90. By comparison, the premium for 2025 was $185. In addition, the deductible in Part ...
Despite their inclusion on a “Hospital Crisis Watch” list, Battle Mountain General Hospital and Humboldt General Hospital are not at immediate risk of closing after federal health care spending cuts this summer. Both were included on Protect Our Care’s list of at-risk rural hospitals, defined as either being in the top 10% Medicaid payer mix ...