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.

Where Trump And Biden Stand On Social Security And Medicare

As Americans tuned into the presidential debate last Thursday, critical issues like Social Security and Medicare came up. These programs act as lifelines for millions of Americans, especially seniors who have historically been a strong voting block.

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California Voters Will Decide Who Wins On Health Care Tax: Gavin Newsom Or Doctors

The health care industry put a measure on the November ballot that would raise more money for Medi-Cal and block lawmakers from spending it on general government services. Billions of dollars are on the line.

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Biden Administration To Lower Costs For 64 Drugs Through Inflation Penalties On Drugmakers

A provision of Biden’s Inflation Reduction Act requires drugmakers to pay rebates to Medicare if they hike the price of a medication faster than the rate of inflation.

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California Leaders Tussle With Health Industry Over Billions of New Dollars for Medi-Cal

Gov. Gavin Newsom, state lawmakers, and health industry leaders have a small window to reach an agreement on billions of new dollars for Medi-Cal before it’s put to voters in November.

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Medicaid for Millions in America Hinges on Deloitte-Run Systems Plagued by Errors

(Editor’s Note: the KFF Health story identified California as having in excess of $500 million in Deloitte Medicaid contracts) Deloitte, a global consultancy that reported revenue last year of $65 billion, pulls in billions of dollars from states and the federal government for supplying technology it says will modernize Medicaid. The company promotes itself as the industry ...

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Mark Cuban’s D2C Pharmacy Won’t Beat Most Insured Patients’ Out Of Pocket Drug Prices, One Study Finds

Insured patients are often better off buying their generic prescriptions through their health insurance benefits than through Mark Cuban Cost Plus Drug Company, though those without insurance could find cost savings in over a quarter of their pharmacy fills, according to a study published Friday in JAMA Health Forum. Across a sample of nearly 844 ...

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Few People Disqualified From Medicaid Are Enrolling In Nevada’s Insurance Exchange

Since Nevada Medicaid resumed eligibility checks for beneficiaries in June of last year, only an average of 5 percent of Nevadans deemed ineligible for the publicly funded insurance program each month have managed to enroll in a plan through the state’s health insurance exchange.

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CMS Confirms Medicare Advantage Quality Ratings To Get New Calculations

The Centers for Medicare & Medicaid Services (CMS) will rework Medicare Advantage (MA) quality ratings for this year. Private insurers will treat the decision as good news, as some health plans could receive “hundreds of millions in additional payments,” The Wall Street Journal first reported June 13. SCAN Health Plan and Elevance Health recently took CMS to court over a ...

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California Will Refund More Than $52 Million To Federal Government For Immigrant Care

California needs to repay more than $52 million to the federal government after improperly claiming reimbursement from the Medicaid program for some immigrant patients, according to a recently released report from federal inspectors.

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Medicare Advantage Plan Sellers Fight CMS Agent Pay Cap In Court

Medicare Advantage plan brokers and distributors are asking the federal courts to give them immediate protection against new Centers for Medicare and Medicaid Services agent compensation rules. The plaintiffs predict in three separate suits that plan distribution channels will break down if the courts fail to block the agent comp rules for the 2025 coverage ...

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