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.

Medicaid Unwinding And The Impact On Group And Individual Health Insurance Markets

The Families First Coronavirus Response Act (FFCRA), signed into law in March 2020, created the first major lifeline for Americans during the onset of the COVID-19 pandemic. It particularly addressed the immediate needs of working Americans who had suddenly lost their paychecks and/or their jobs – and their subsequent eligibilities for health insurance. Now that ...

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Medicare Spending Could Increase $2 To $5 Billion If Coverage Expands For Lecanemab

Medicare annual spending on lecanemab's medication costs alone would place it among the most expensive Part B medications.

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Drugmakers Set Strategy For Legal Fight Against US Pricing Regulation

Some of the world’s biggest drugmakers are laying legal groundwork to fight the U.S. plan to negotiate drug prices for its Medicare health coverage, including the argument that a ban against speaking about these talks violates constitutional rights, according to six industry sources. The Biden Administration’s signature drug pricing reform, part of the Inflation Reduction ...

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First Wave of Nevada Medicaid Redeterminations Happening Now

As the state unwinds from the federal public health emergency, the Division of Welfare and Supportive Services (DWSS)  has begun the reevaluation of all Medicaid enrollments for the first time since 2020 during which you may lose coverage under Medicaid. In April, the first wave of recipients received their renewal packets in the mail. Those who ...

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Expanded Hospital Tax Could Boost Medicaid Rates, Fund Behavioral Health Services

Nevada’s lack of state-supported services for child mental health issues has been described as a “crisis” — underscored by a federal investigation last year revealing that the state’s lack of adequate treatment and services to children and youth with behavioral health disabilities likely violated federal law.

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OIG Finds $580 Million In Improper Psychotherapy Medicare Payments

The popularity and utility of telehealth has made it a more common form of healthcare delivery since the start of the COVID-19 pandemic, and telepsychiatry is one of the most used applications for the remote care technology. But the Department of Health and Human Services’ Office of the Inspector General has found that an estimated $580 million ...

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The Biden-Harris Administration Proposes New Standards to Help Ensure Access to Quality Health Care in Medicaid and CHIP

The Centers for Medicare & Medicaid Services (CMS) today unveiled two notices of proposed rulemaking (NPRMs), Ensuring Access to Medicaid Services (Access NPRM) and Managed Care Access, Finance, and Quality (Managed Care NPRM), that together would further strengthen access to and quality of care across Medicaid and the Children’s Health Insurance Program (CHIP), the nation’s largest health coverage programs. ...

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Nevada Medicaid Warns Of Renewal Scams

Scammers are targeting Nevadans who need to reapply for Medicaid or transition to other insurance, state officials warned Monday.

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Attempts To Scam Medicaid Members Popping Up Nationwide As Unwinding Commences

Compounding the already unprecedented scale and scope of the national effort to conduct eligibility checks for all 91 million Americans who have Medicaid as their health insurer, Medicaid agencies and their leaders were hit with a new challenge. The scammers and bad actors have seized on this as a way to make a quick buck ...

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FAQs About The Inflation Reduction Act’s Medicare Drug Price Negotiation Program

The Inflation Reduction Act of 2022 (the Act), signed into law by President Biden in August 2022, includes several provisions to lower prescription drug costs for people with Medicare and reduce drug spending by the federal government. One of the Act’s key drug-related policies is a requirement for the Secretary of Health and Human Services (HHS) to negotiate prices ...

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