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.

Playing On Fear And Fun, Hospitals Follow Pharma In Direct-To-Consumer Advertising

The scene is shadowy, and the background music foreboding. On the TV screen, a stream of beleaguered humans stand in an unending line.

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Primary Care Physician Visits Drop Among Patients with Employer Plans

NPs and PAs have recently taken on a larger role in primary care. Health experts say those roles will help fill primary care gaps in the coming years with physician shortages expected.

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Waiting on 2 States, CVS Delays Aetna Deal Closing Until After Thanksgiving

CVS expects to close its $69 billion acquisition of Aetna after the Thanksgiving holiday. 

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Express Scripts Ramps Up List-Price Pressure With Newfangled ‘Flex’ Formulary

During a yearslong examination of drug prices, there’s been no shortage of criticism for growing list prices, and in recent months, some companies have heard the talk and lowered their prices. Now, top PBM Express Scripts is rolling out a new formulary to help support the moves—and the plan could heap more pressure on players in competitive drug classes.

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Breach of Obamacare Site Spilled Sensitive Data

More than two weeks after announcing that the Obamacare website, HealthCare.gov, had been hacked, the Department of Health and Human Services has revealed that the breach exposed a wealth of information, including partial Social Security numbers and immigration status.

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Billions In Questionable Medi-Cal Payments

California’s Medicaid program made at least $4 billion in questionable payments to health insurers and medical providers over a four-year period because as many as 453,000 people were ineligible for the public benefits, according to a state audit released Tuesday.

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Congressional Report Says Insulin Market Benefits Drugmakers and Insurers, Not Patients

“Perverse” incentives in the insulin supply chain lead to artificially high prices, as well as limited competition in the markets, according to a bipartisan report released Thursday by two lawmakers.

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Despite Criticism and Concerns, FDA Approves A New Opioid 10 Times More Powerful than Fentanyl

In a highly controversial move, the Food and Drug Administration approved an especially powerful opioid painkiller despite criticism that the medicine could be a “danger” to public health. And in doing so, the agency addressed wider regulatory thinking for endorsing such a medicine amid nationwide angst about overdoses and deaths attributed to opioids.

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California Nurses Move Their ‘Medicare-for-all’ Fight to the National Stage

The union representing 100,000 nurses across California has shifted its “Medicare-for-all” campaign from California to the national stage, perhaps relieving political pressure on Democratic gubernatorial candidate Gavin Newsom to fulfill what the union sees as his top campaign promise: Delivering a single-payer health care system in the nation’s largest state.

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Booming Economy Helps Flatten Medicaid Enrollment And Limit Costs, States Report

Medicaid enrollment fell by 0.6 percent in 2018 — its first drop since 2007 — due to the strong economy and increased efforts in some states to verify eligibility, a new report finds.

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