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.
Despite having survived a challenge in the U.S. Supreme Court, the federal government’s health insurance markets face weighty struggles as they try to keep prices under control, entice more consumers and encourage quality medical care. The government’s insurance markets – as well as more than a dozen run by states — have been operating for ...
State employees and covered family members will have health coverage for gender reassignment and other transgender procedures under a new insurance policy that takes effect July 1. The Public Employee Benefits Program board voted in November to remove language in the state’s self-funded and HMO plans that specifically excluded therapy for gender dysphoria. Brock Maylath, ...
A California lawsuit accuses two surgeons and four hospitals in Las Vegas of participating in a massive health care fraud scheme that involved implanting counterfeit spinal hardware into unsuspecting patients. The case, filed in February by dozens of insurance companies in Los Angeles County Superior Court, was recently unsealed. According to the lawsuit, California-based Spinal ...
Gov. Brian Sandoval on Monday appointed Richard Whitley director of the Department of Health and Human Services. Whitley, former administrator of the Division of Public and Behavioral Health, has been interim director of the huge state agency since February. “Richard has proven to be a steady and capable leader and I am pleased to make ...
Nevada Commissioner of Insurance Scott J. Kipper announced Thursday his resignation effective July 2. “It has been an honor to have served the state of Nevada as commissioner,” Kipper said. “I am proud of the division’s accomplishments. I am certain that the Division of Insurance will continue to serve the consumers, protecting the rights of ...
California health officials failed to ensure that more than 9 million residents enrolled in Medi-Cal managed care plans had access to doctors when they needed them, the state auditor said in a stinging report Tuesday. Health officials might have learned about those problems from calls to an ombudsman’s office – but thousands went unanswered every ...
Gov. Jerry Brown (D) last week issued a proclamation to convene a special legislative session on health care spending on the same day he agreed to a state budget that had many of its health-related provisions negotiated away. Financing the Medi-Cal program may not be sustainable, Brown said, given its expansion over the past two years ...
Medi-Cal enrollment has increased by 34% since the Affordable Care Act went into effect, leading all other Medicaid programs in the country in terms of total beneficiaries, according to data from the Kaiser Family Foundation, HealthyCal reports. Medi-Cal is California’s Medicaid program. Details of Increase in Enrollment California — one of 29 states that have ...
WASHINGTON — The government relies too heavily on advice from the American Medical Association in deciding how much to pay doctors under Medicare, and the decisions may be biased because the doctors have potential conflicts of interest, federal investigators say in a new report. This reliance on the association, combined with flaws in data collected by the ...
On Monday, CMS publicly released new online data that reveal hospitals’ Medicare charges and payments, as well as what doctors billed, in 2013, Modern Healthcare reports (Herman, Modern Healthcare, 6/1). Background The data were unveiled at the Health Datapalooza conference in Washington, D.C. (CMS release, 6/1). It is the third straight year that Medicare has ...