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.
Medicare beneficiaries stand to lose access to two key virtual care programs that the federal government has offered since the start of the pandemic if the government shuts down Tuesday at midnight. The Medicare telehealth waivers and Acute Hospital at Home programs are set to expire Oct. 1 unless Congress passes a short-term government funding ...
The Trump administration projects average Medicare Advantage (MA) premiums will decline slightly for the 2026 plan year. The Centers for Medicare & Medicaid Services (CMS) announced Friday that the average monthly premium across all types of MA coverage is set to be $14, down from $16.40 in 2025. This includes MA plans with prescription drug coverage as ...
The House passed a Republican-backed measure, largely along party lines, that would push the shutdown deadline to Nov. 21. But then the Senate rejected a Democrat-led proposal that would keep the government open through Oct. 31, as well as implement several Democratic priorities.
Every day for nearly 18 years, Alessandra Fabrello has been a medical caregiver for her son, on top of being his mom. “It is almost impossible to explain what it takes to keep a child alive who should be dead,” said Fabrello, whose son, Ysadore Maklakoff, experienced a rare brain condition called acute necrotizing encephalopathy ...
By October 14, 2025, employers with plans providing prescription drug coverage must distribute Medicare Part D creditable coverage notices. These notices help Medicare-eligible individuals – employees and dependent(s), including those eligible due to disability or End-Stage Renal Disease (ESRD) – decide whether to keep employer coverage or enroll in Part D for 2026. Here’s the good ...
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 ...