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.
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. ...
Facing the wrath of upset investors following its first quarter earnings, CVS Health has promised to value margins over members going forward. First apologizing for last quarter’s earnings, which were plagued by higher-than-expected Medicare Advantage (MA) utilization, CFO Thomas Cowhey told the Bank of America Securities 2024 Health Care Conference crowd that CVS remains a big ...
More than 20% of Medicare Advantage patients could be affected by the rule, report finds.
Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments as a likely culprit in this increase in coding intensity.
The gap between insurance plans and Medicare's payments to hospitals for inpatient and outpatient services widened over the course of just a couple of years, a new study from RAND Corporation finds.
For much of his young life, Jorge Sanchez regularly gasped for air, at times coughing so violently that he’d almost throw up. His mother whisked him to the emergency room late at night and slept with him to make sure he didn’t stop breathing. “He’s had these problems since he was born, and I couldn’t ...
More than half of all fee-for-service Medicare enrollees without any additional coverage chose a Medicare Supplement plan in 2021.
Healthcare and drug industry groups on Wednesday urged a U.S. appeals court to revive their challenge to a law requiring manufacturers to negotiate the prices of some drugs with the U.S government’s Medicare health insurance program or pay heavy penalties. Pharmaceutical Research and Manufacturers of America (PhRMA), the Global Colon Cancer Association and the National ...