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.
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.
(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 ...
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 ...
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.
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 ...
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.
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 ...
Months into a new Biden administration policy intended to lower drug costs for Medicare patients, independent pharmacists say they’re struggling to afford to keep some prescription drugs in stock. “It would not matter if the governor himself walked in and said, ‘I need to get this prescription filled,’” said Clint Hopkins, a pharmacist and co-owner ...
America’s Health Insurance Plans is meeting in Las Vegas this week, and everything has changed. A year ago, the health insurers that belong to AHIP were focusing on efforts to expand and improve Medicare plan operations. UnitedHealth was excited about its newly acquired Change Healthcare health data services unit. This year, the Centers for Medicare ...
It’s important to be on the lookout for scams every day of the year, but during Medicare Fraud Prevention Week June 3-9, Blue Shield of California warns its Medicare beneficiaries about scammers who want their personal, financial, and health plan information. Healthcare fraud in the U.S. is an enormous, expensive problem — costing up to $300 billion, according to the National Health Care Anti-Fraud Association. ...