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.
More than 600,000 Americans have lost Medicaid coverage since pandemic protections ended on April 1. And a KFF Health News analysis of state data shows the vast majority were removed from state rolls for not completing paperwork. Under normal circumstances, states review their Medicaid enrollment lists regularly to ensure every recipient qualifies for coverage. But because ...
The U.S. Medicare health plan said on Thursday it would limit reimbursement for Eisai Co Ltd (4523.T) and Biogen Inc’s (BIIB.O) Alzheimer’s drug Leqembi to patients whose doctors participate in a health agency database should the drug win full approval, a move advocates say will hinder its use. The decision marks the first time that Medicare has required data-collection ...
Dive Brief: CVS expects its 2024 operating income to drop by $800 million to $1 billion next year due to lost bonus payments from lower plan star ratings in the Medicare Advantage program. Just 21% of CVS’ MA members are currently in plans with a star rating of at least four, down from 87% at the ...
Democrats beat back efforts to attach Medicaid work requirements to a debt limit deal, but the agreement reached over the weekend will claw back about $30 billion of unspent COVID relief funds and likely bring more budget austerity to federal health agencies. Why it matters: GOP negotiators had increasingly insisted that Medicaid work requirements needed to ...
The Biden administration issued a proposed rule Tuesday that aims to shed light on the price of prescription drugs covered by Medicaid. Under the proposal (PDF), pharmacy benefit managers, or pharmacy middlemen, that contract with Medicaid would have to disclose the prices they pay for medications in an effort to improve price transparency and pull the reins on ...
States were given the green light to begin Medicaid redeterminations in early April, yet many enrollees are still unaware of the process, according to a new survey. KFF analysts polled a representative sample of 3,605 people with a range of insurance types earlier this year and found that 65% of Medicaid members are unsure whether states can ...
Through a budget committee vote in May, state lawmakers reversed Gov. Joe Lombardo’s proposed cuts to the state-run public health insurance option popularly called the “public option” — a measure passed during the 2021 legislative session that Lombardo called “bullshit” on the campaign trail. But as part of that meeting, in a move that went ...
Key progressives in the House and Senate have revived the fight in Congress over "Medicare for All," a single-payer health system based on the Medicare program.
Medicare Advantage plans’ use of third-party algorithms for coverage determinations is facing some scrutiny in the Senate. Lawmakers in a Wednesday hearing argued something must be done to pare back burdensome prior authorization requirements allowing payers to delay or deny medical care that would be covered under traditional Medicare — including the use of artificial intelligence ...
Patient demand for GLP-1 weight loss drugs is continuing to grow, and, if Medicare were to expand coverage to meet that demand, it could cost the program billions each year, according to a new analysis. Traditional Medicare does not currently cover these drugs, which include brand names like Novo Nordisk’s Ozempic and Wegovy, for weight loss. ...