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.
Health insurers are seeking lofty rate hikes for 2019 individual coverage as they grapple with new obstacles in the Affordable Care Act marketplace, including the zeroed-out mandate penalty and the potential influx of skimpy insurance policies.
The coupons typically offer patients with commercial insurance a break on their copayment for brand-name drugs, often reducing their out-of-pocket costs to what they would pay for inexpensive generic drugs.
Medicare will require hospitals to post their standard prices online and make electronic medical records more readily available to patients, officials said Tuesday.
California on Monday jumped into the middle of a legal dispute over the future of the federal Affordable Care Act, seeking to preserve the law that is under assault in the courts by 20 other states.
Today the California Department of Insurance (CDI) reached a $5 million settlement agreement with HCC Life Insurance Company stemming from a multistate market conduct examination of HCC Life's short-term health insurance business. As part of the $5 million multistate payment, California will receive just over $1 million.
The CMS finalized a rule Monday giving Medicare Advantage plans a 3.4% pay hike in 2019. That's well above the 1.84% bump the agency initially proposed and higher that the 2.95% increase for 2018.
Sarah Hesketh of the California Association of Public Hospitals — which represents 21 hospitals that are all both disproportionately reliant on Medicaid and enrolled in 340B — said that should providers decide to stay enrolled in 340B to get discounts for their Medicare patients they would continue to be subject to the 340B provider rules banning them from group negotiations for lower drug prices. This would have the unintended consequence of hurting the providers who care for the most Medicaid patients.
California Medicaid Expansion Enrolled Hundreds of Thousands Ineligible People, Federal Report Finds
California signed up an estimated 450,000 people under Medicaid expansion who may not have been eligible for coverage, according to a report by the U.S. Health and Human Services Department's chief watchdog.
Health insurer Cigna is buying the nation’s biggest pharmacy benefit manager, Express Scripts, the latest in a string of proposed tie-ups as health care’s bill payers attempt to get a grip on rising costs.
The practice of charging a copay that is higher than the full cost of a drug is called a “clawback” because the middlemen that handle drug claims for insurance companies essentially “claw back” the extra dollars from the pharmacy.