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.

Consumers With COBRA Coverage Should Weigh Moving To Health Law Plans

As the open enrollment season for employer-sponsored health insurance gets underway this fall, experts say there’s one group that should definitely consider changing plans: people who have coverage through their former employer under the federal law known as COBRA. COBRA allows people who leave their jobs to keep their job-based group coverage for 18 months, ...

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New Medicare Advantage Pilot To Test Value-Based Insurance Design

On Tuesday, the Center for Medicare and Medicaid Innovation at CMS announced a new pilot program that will allow Medicare Advantage insurers to lower beneficiaries’ out-of-pocket costs as a way to encourage them to use high-quality services and potentially reduce overall costs in the long term, Modern Healthcare reports. The five-year program begins Jan. 1, ...

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What Medicare’s Value-Based Insurance Test Could Mean for Commercial Plans

A new test within the Medicare Advantage program will lower out-of-pocket costs for chronically ill patients who seek high-value services and providers. Supporters hope the project will lead to changes in federal law and become a template for all health plans with sizable cost-sharing, which have become the standard offering from employers and insurers. But ...

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California Passes Bill Delaying Transfer of Fragile Kids Into Managed Care

California legislators passed a bill postponing a controversial plan that would have shifted tens of thousands of medically fragile children into Medi-Cal managed care plans. The bill, AB 187, passed both houses Thursday and will be sent to Gov. Jerry Brown for his signature. At issue was the fate of the California Children’s Services program, ...

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Health Plans Come Out Against Tax Bills

California’s largest health plan group this week declared its opposition to both of the healthcare special session bills that would impose new taxes on managed-care organizations, the latest sign that a replacement for a soon-to-expire health plan tax is unlikely to emerge before lawmakers adjourn next week. Health plan taxation is the focus of the ...

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Democrat Drops Covered California Waiver for Immigrants

SACRAMENTO, Calif. (AP) – A Democratic state lawmaker on Friday dropped his effort to allow people who are in the country illegally to buy private insurance through the state’s health insurance marketplace. Sen. Ricardo Lara, D-Bell Gardens, removed language seeking a federal waiver that would allow immigrants to purchase unsubsidized coverage through Covered California. His ...

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White House Takes Aim At Medicare And Medicaid Billing Errors

White House budget director Shaun Donovan called for a “more aggressive strategy” to thwart improper government payments to doctors, hospitals and insurance companies in a previously undisclosed letter to Health and Human Services Secretary Sylvia Mathews Burwell earlier this year. Government health care programs covering millions of Americans waste billions of tax dollars every year ...

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Drug-Industry Rule Would Raise Medicare Costs

A patent law change sought by the pharmaceutical industry could cost federal health-care programs $1.3 billion over a decade by delaying new generic medicines, an analysis by the Congressional Budget Office found this summer, according to people familiar with the matter. Pharmaceutical trade groups are asking Congress to exempt drug patents from being challenged through ...

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Federal Healthcare Spending Projections Inch Upward

Federal spending on Medicare, Medicaid, the Children’s Health Insurance Program and exchange subsidies will rise from 5.2% of the country’s economic output in 2015 to 6.2% in 2025, the Congressional Budget Office said Tuesday inupdated budget projections (PDF). The CBO said in its March report that those healthcare programs would constitute 6.1% of the country’s ...

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With Mergers, Concerns Grown About Private Medicare

As some of the nation’s largest health insurers plan to merge, a new report raises fresh concern over the lack of competition in the private Medicare market.

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