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 Centers for Medicare & Medicaid Services (CMS) has released new data on risk adjustment payments for 2023. The agency said (PDF) insurers participating on the Affordable Care Act’s exchanges will pay $10.3 billion as part of the risk adjustment program. Risk adjustment state transfers as a percent of premiums declined from 2022, according to the report. ...
The Inflation Reduction Act calls for prescription drug prices for seniors on Medicare to be lowered and out-of-pocket expenses capped at $2,000 per year starting in 2025, the White House said. The act also capped the price of insulin, which helps regulate diabetes, at $35 a month for Medicare users.
The Wall Street Journal has added to the pressure on Medicare Advantage plan issuers by publishing its own analysis of how the issuers score their enrollees' health.
The sweeping payment rule also solidifies continuous eligibility requirements for children in Medicaid and CHIP, and holds hospitals to higher obstetric care delivery standards.
Private insurance firms running Medicare Advantage programs have been overcharging the federal government billions of dollars by making patients look sicker than they really are, according to a report in The Wall Street Journal on Monday.
As Americans tuned into the presidential debate last Thursday, critical issues like Social Security and Medicare came up. These programs act as lifelines for millions of Americans, especially seniors who have historically been a strong voting block.
The health care industry put a measure on the November ballot that would raise more money for Medi-Cal and block lawmakers from spending it on general government services. Billions of dollars are on the line.
A provision of Biden’s Inflation Reduction Act requires drugmakers to pay rebates to Medicare if they hike the price of a medication faster than the rate of inflation.
Gov. Gavin Newsom, state lawmakers, and health industry leaders have a small window to reach an agreement on billions of new dollars for Medi-Cal before it’s put to voters in November.
(Editor’s Note: the KFF Health story identified California as having in excess of $500 million in Deloitte Medicaid contracts) Deloitte, a global consultancy that reported revenue last year of $65 billion, pulls in billions of dollars from states and the federal government for supplying technology it says will modernize Medicaid. The company promotes itself as the industry ...