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.

Fitch Ratings Says Medicaid Disenrollment Will Pinch Revenue for Not-For-Profit Hospitals

Gary Sokolow, a director in Fitch Ratings’ public finance healthcare group, told Fierce Healthcare that nonprofit hospitals didn’t have to worry for the past three years about taking care of patients showing up in their emergency rooms because many of those patients were either Medicaid beneficiaries or could be automatically enrolled in the program while the eligibility ...

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July Goal Set For Final U.S. Medicare Drug Negotiation Guidance

The U.S. government aims to publish the final guidance for its Medicare drug price negotiation program in early July and is currently talking to companies about its contents, a top health official said on Wednesday. The guidance will finalize the details of how President Joe Biden’s signature drug pricing reform will be carried out. The ...

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HHS Quietly Trims Inaugural List Of Price Capped Medicare Drugs From 27 To 20

The Department of Health and Human Services’ (HHS’) highly publicized list of the first Medicare Part B prescription drugs hit with rebates under the Inflation Reduction Act discreetly dropped from 27 to 20, prompting critiques from the pharma lobby over the Biden administration’s swift implementation of the legislation’s drug controls. As spotted by Endpoints, the press release and ...

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Providers, Payers Press CMS To Get Rid Of Medicare Advantage Risk Adjustment Changes Entirely

While provider and payer groups were happy that the Biden administration delayed implementation of changes to Medicare Advantage’s (MA’s) risk adjustment model, they hinted at a sustained campaign to get rid of them entirely. Industry reaction to the final 2024 MA payment rule released late Friday details the next fight the Centers for Medicare & Medicaid Services ...

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Medi-Cal Will Soon End Some People’s Benefits. What This Means For You

Since the COVID-19 pandemic began in earnest, low-income Californians who enrolled in Medi-Cal — California’s version of the government-funded Medicaid health insurance program — have been able to keep their coverage without having to prove every year that they still qualified for it. That’s because the Families First Coronavirus Response Act, which President Trump signed ...

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CMS To Raise Medicare Advantage Pay Rates By 3.3% In 2024; Phase In Risk Adjustment Changes

The Biden administration finalized a proposal to raise Medicare Advantage payments by 3.32% in 2024, slightly above the 1% raise that it proposed. The final payment rule released Friday comes after an intense lobbying campaign from insurers who claimed that the original advance notice released in February would amount to a cut to plans. The ...

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How Medicare Advantage Could Become A Marquee Issue In Nevada’s 2024 Senate Race

When President Joe Biden delivered his State of the Union address to Congress in February, he drew a clear distinction on entitlement spending – his administration had pledged to protect Social Security and Medicare, while congressional Republicans were trying to cut them.

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Mobile Clinics Really Got Rolling in the Pandemic. A New Law Will Help Them Cast a Wider Safety Net.

Nearly 12 years ago, a nonprofit centered on substance abuse prevention in Lyon County, Nevada, broadened its services to dental care. Leaders with the Healthy Communities Coalition were shocked into action after two of their food pantry volunteers used pliers to pull each other’s abscessed teeth. The volunteers saw no other option to relieve their ...

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Prescription for Housing? California Wants Medicaid to Cover 6 Months of Rent

Gov. Gavin Newsom, whose administration is struggling to contain a worsening homelessness crisis despite record spending, is trying something bold: tapping federal health care funding to cover rent for homeless people and those at risk of losing their housing. States are barred from using federal Medicaid dollars to pay directly for rent, but California’s governor is ...

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Providers Want CMS To Create New Payment Methods To Boost Primary Care

A collection of nearly 30 provider groups wants the Biden administration to combine fee-for-service and prospective payments to primary care doctors to bolster the workforce. The groups wrote a letter to officials with the (PDF) Centers for Medicare & Medicaid Services (CMS) on the need for such a hybrid payment model. The missive comes as CMS has ...

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