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.
U.S. President Donald Trump announced Friday that nine drugmakers have agreed to lower the cost of their prescription drugs in the U.S. Pharmaceutical companies Amgen, Bristol Myers Squibb, Boehringer Ingelheim, Genentech, Gilead Sciences, GSK, Merck, Novartis and Sanofi will now rein in Medicaid drug prices to match what they charged in other developed countries. As ...
The Trump administration proposed new payment cuts in Medicare for prescription drugs, even as pharmaceutical companies struck deals with the government in an effort to avoid just such measures. Friday evening, after an event with drugmakers at the White House, the administration said it plans to slash what Medicare pays for certain medicines administered in physicians’ offices ...
In July, the Trump administration passed the One Big Beautiful Bill Act, otherwise known as the budget reconciliation bill. The law, H.R. 1, has made waves for its historic nearly $1 trillion cut to federal Medicaid spending over 10 years. Healthcare stakeholders have been vocal opponents of the move. H.R. 1 brings the first-ever national work requirements to the ...
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 ...