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.
Starting next year, Medicare Advantage plans will be able to add restrictions on expensive, injectable drugs administered by doctors to treat cancer, rheumatoid arthritis, macular degeneration and other serious diseases.
When Paul Lyons opened a primary-care practice in the Palm Springs area for low-income patients, the need was clear.
Improving consumers’ healthcare literacy could save the U.S. healthcare system billions of dollars per year, according to a new analysis from Accenture.
Nevada Medicaid will reverse its decision to require prior authorization for mental health services after providers and patients raised concerns that the policy change could delay treatment.
A lawsuit has been filed on behalf of three Dignity Health nurses claiming they were required to perform off-the-clock work and were subject to impermissible rounding of time entered on timecard software and an employee monitoring system hospital staff use to record hours worked.
Former President Obama on Friday called "Medicare for all" a "good" idea during a speech in Illinois where he launched his midterm campaign efforts for Democrats.
The Centers for Medicare & Medicaid Services (CMS) issued a memo today to Medicare Part D plans, which cover prescription drugs that beneficiaries pick up at a pharmacy, offering plans new tools and flexibility to expand choices and lower drug prices for patients.
Health insurers have perfected a way to wring billions more in revenue from the Medicare program by combing patient medical charts for additional diagnosis codes to submit to the federal government for payment.
“What I worry about the most is the agents and brokers” selling the plans, Kreidler said. “They are looking at the [large] commission, and that blinds them to their legal responsibility” to inform consumers about the limitations of the short-term plans.
Accountable care organizations were among the key initiatives of the Affordable Care Act, designed to help control soaring Medicare costs. ACOs were expected to save the government nearly $5 billion by 2019, according to the Congressional Budget Office. It hasn’t come anywhere close.