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.
State officials remain uncertain on how to enforce a requirement that many adult Medicaid enrollees show they’re working — even as one state launches its program this week — and they’re taking a variety of approaches to the job, including, in a handful of states, using artificial intelligence. A KFF survey of Medicaid officials from 42 states and the ...
Big health insurers said today that they will standardize the process for submitting requests for prior authorizations for coverage for many common procedures by Jan. 1, 2027. Managers of the standards effort will start by applying it to “medical services that are commonly subject to prior authorization, such as orthopedic surgeries and imaging services, including ...
After decades of selling insurance, Illinois-based broker John Jaggi had never seen anything like it. More than 80 of his customers who were enrolled in the same Medicare supplemental plan from the insurer Chubb got hit last August with a 45% increase. “In my 49 years of doing biz as a broker, I’ve never seen ...
Officials have failed to halt pervasive fraud in the hospice industry despite promises of reforms five years ago after learning of widespread corruption that targeted vulnerable patients. California authorities promised to crack down after a Times investigation in late 2020 revealed that a cohort of mostly older Americans was being targeted by unscrupulous providers who ...
The system of paying Medicare agents and brokers more money if they enroll someone in a Medicare Advantage plan rather than traditional Medicare with a supplement plan needs to be changed, according to several members of the Medicare Payment Advisory Commission (MedPAC). “The broker compensation piece really frustrates me,” MedPAC member Stacie Dusetzina, PhD, of ...
Dozens of provider and patient advocacy associations are putting their weight behind a newly introduced bill they say will promote better management of Medicare patients with multiple chronic conditions. The bipartisan Chronic Care Management Improvement Act targets a copayment that beneficiaries must agree to before they may receive a slew of behind-the-scenes services coordinating their records and ...
The National Association of Benefits and Insurance Professionals (NABIP) today announced significant policy victories for agents, brokers, and the millions of Medicare beneficiaries they serve following the release of CMS’s Contract year 2027 Medicare Advantage and Part D Final Rule. The final rule reflects a strong alignment with NABIP’s advocacy to modernize Medicare marketing and ...
A new report distills the Trump administration’s strategy as officials jockey to shape health care messages ahead of this year’s midterm elections.
Each year, the National Association of Benefits and Insurance Professionals (NABIP) gathers in Washington, D.C., for its Capitol Conference, bringing together hundreds of agents, benefits specialists, and industry leaders to engage directly with federal policymakers. The event serves as a coordinated advocacy effort, where NABIP members from across the country deliver a unified message to ...
Following significant industry outcry over a proposal to keep Medicare Advantage rates largely flat in 2027, the Trump administration has bumped payments up slightly in the final policy. The Centers for Medicare & Medicaid Services initially proposed a 0.09% increase in rates as part of the MA and Part D Advance Notice. In the final rule, the increase ...