Medicare Medicaid Category

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.

CMS Releases Rules On Wait Times And Payment Standards In Medicaid

Rule requires 80% of Medicaid Home and Community Based Services payments directly compensate workers rather than "administrative overhead."

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Medicare’s Push To Improve Chronic Care Attracts Businesses, but Not Many Doctors

Carrie Lester looks forward to the phone call every Thursday from her doctors’ medical assistant, who asks how she’s doing and if she needs prescription refills. The assistant counsels her on dealing with anxiety and her other health issues. Lester credits the chats for keeping her out of the hospital and reducing the need for ...

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CMS Final Rule On Broker Comp, Health Equity Could Shake Up Medicare Advantage

Centers for Medicare & Medicaid Services finalized a host of actions ranging from broker compensation, health equity, mental health, supplemental benefits and biosimiliars, in the Contract Year 2025 Medicare Advantage and Part D final rule Thursday night.

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Medicare Spending On Ozempic Sees Huge Spikes

Total gross Medicare spending on GLP-1 drugs has skyrocketed, rising from $57 million in 2018 to $5.7 billion in 2022.

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Biden Expands Window To Try And Keep Millions More Low-Income Americans Insured

President Joe Biden is widening a critical window for low-income Americans to join Obamacare, in a move aimed at reinforcing a central element of his reelection bid: That he presided over a historic expansion of health care coverage.

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Kaiser Permanente-Backed Habitat Health To Offer PACE Services In 2025

Kaiser Permanente and a pair of investment firms have unveiled a joint venture to help older, low-income adults receive care support without needing to be moved from their homes.

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The Future of Medicare Advantage

This year US health insurers have to navigate strong crosscurrents from demographic shifts, regulatory changes, and member preferences. How they react now can have an impact for years to come.

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Medicare Advantage Plans To See 2025 Base Pay Fall

The Biden administration on Monday followed through on its proposal to cut next year’s base payments to Medicare Advantage plans an average of 0.16%, despite pressure from insurers and their allies in Congress. Why it matters: While the plans will wind up seeing a net increase once payments are risk-adjusted to account for the health of their customers, ...

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Will Medicare Raise Your Monthly Premiums To Cover Wegovy?

Some Medicare prescription plans will start paying for weight-loss medications for people with heart disease.

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Payers Say MA Rate Cut Puts Affordable Care At Risk

As expected, insurance-friendly groups are upset over the feds’ MA benchmark payment decision Monday. Global strategy firm Capstone said the CMS decision most negatively impacts Humana, UnitedHealth Group, Elevance Health, Cigna and certain providers like Agilon that were expecting high utilization rates last quarter to be represented in the growth rate, which decreased compared to ...

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