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.
Drugmakers around the globe are bracing for a major shakeup in how one of their largest customers does business. On Sept. 1, Medicare will target its first 10 drugs for historic price negotiations. The medications are sure to be among the country's costliest and will likely include common treatments for cancer and diabetes.
Most Medicare Advantage (MA) enrollees use one or more supplemental benefits, with most health plan members using multiple benefits, according to a newly released report from the Elevance Health Public Policy Institute.
In what the Centers for Medicare & Medicaid Services (CMS) today described as a “parity adjustment recalibration,” the agency said it will increase payments to skilled nursing facilities by 4%, or $1.4 billion, starting in fiscal year 2024. The payment bump will, in part, make up for a $2.2 billion underpayment to the facilities as a result of the ...
About 225,0000 Californians lost their free or low-cost health coverage as of July 1, in the first round of a Medi-Cal renewal process that had been suspended since early in the COVID-19 pandemic. That’s approximately 21% of the over 1 million people who were due to reapply for coverage in June, according to preliminary numbers ...
Medicare Advantage plans could end up getting too much money from the government — by as much as $1.6 trillion — over the next decade, putting pressure on the trust fund that supports Medicare. This forecast comes from the Committee for a Responsible Federal Budget, which looked at the intricacies of insurance coding, as well ...
U.S. pharmaceutical company Johnson & Johnson (J&J) announced Tuesday it is suing the Department of Health and Human Services (HHS) over Medicare Drug Price Negotiation Program, becoming the latest of several organizations challenging the provision established by the Inflation Reduction Act. J&J joins fellow pharmaceutical companies Merck & Co., Bristol Myers Squibb as well as ...
It has become as familiar a sight in Washington as the cherry blossoms in spring: lobbyists from the nation’s hospitals descending on the Capitol to ask lawmakers to postpone billions in Medicaid funding cuts prescribed by the Affordable Care Act — cuts industry leaders agreed to years ago.
A budget deal between the governor and the state legislature will expand Medi-Cal reimbursement rates starting next year. Medi-Cal is the state’s health care program covering low-income Californians. Just over a million San Diego County residents rely on Medi-Cal for health care. Advocates hope the move will give recipients more options and better access to ...
Major players in California’s health care field have reached a deal on how they want the state to spend $19 billion in proceeds of a renewed tax on insurance plans plus the federal funds that go with it — a development that followed months of private negotiations between bitter industry rivals, state lawmakers and the governor’s office.
Medicaid Disenrollment Is Happening Faster Than Anyone Thought, Says Former Medicaid Deputy Director
The loss of coverage for Medicaid recipients is happening faster than anyone believed it would, according to Karen Shields, chief client engagement officer at Gainwell Technologies, a large payer of Medicaid claims. “It’s faster than we thought,” said Shields, a former deputy director for the Center for Medicaid and CHIP Services. “The call for action indicates everything ...