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.
Under the new budget signed by Gov. Gavin Newsom, Medi-Cal — the state’s Medicaid program — would no longer cover weight loss drugs, such as Wegovy and Zepbound, unless they’re prescribed to treat diabetes. The measure is intended to promote fiscal responsibility.
Prior authorization is similar to how private insurers operate, often resulting in a delay or denial of treatments
Accountable care organizations saved Medicare $2.4 billion last year, according to new federal data. The Centers for Medicare & Medicaid Services released (PDF) the latest results from the Medicare Shared Savings Program, which shows that 75% of the 476 participating ACOs earned $4.1 billion in performance payments. These organizations represent 80% of the 10.3 million beneficiaries assigned ...
The Department of Health and Human Services (HHS) will seek external experts for a new committee tasked with providing strategic guidance on the care provided by government insurance programs. The HHS announced Thursday that the Healthcare Advisory Committee will offer recommendations to Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet ...
A district court in Texas has ruled against the Department of Health and Human Services, deciding to vacate several provisions imposed last year impacting how Medicare Advantage (MA) plans market products. The Centers for Medicare & Medicaid Services (CMS) finalized a rule in April 2024 that fixed broker and agent compensation and raised the pay ...
A new analysis from the Congressional Budget Office (CBO) warns that Republicans’ massive tax bill could lead to hundreds of billions in cuts to Medicare over the next 10 years. CBO analysts, in a letter (PDF) to key Democratic senators Friday, dug into the potential impact the One Big Beautiful Bill Act could have on federal programs ...
In response to recent federal legislation that cuts billions of dollars to Medicaid, Santa Clara County supervisors on Thursday unanimously voted to add a ballot measure to November’s special election that would increase local sales tax by five-eighths of a cent (0.625%) for five years to try to backfill some of the projected lost federal ...
When President Donald Trump signed a law adding work requirements for some Medicaid recipients, he may have undercut lawmakers in at least 14 states who were designing their own plans, according to health industry observers. Georgia is the only state with a work requirement in place for Medicaid, but several states have been pursuing such ...
House Democrats are sounding the alarm and demanding more information about a new Department of Health and Human Services (HHS) demonstration they say will increase red tape by adding prior authorization requirements in Medicare. Led by Reps. Suzan DelBene (D-Wash.) and Ami Bera (D-Calif.), a group of 17 Democrats questioned why HHS would want to test adding prior authorization ...
The Trump administration is planning an experiment to cover weight loss drugs under Medicare and Medicaid, potentially benefiting millions of Americans struggling with obesity.