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.
The Value in Health Care Act would provide a 2-year extension of the 5% advanced payment model incentives, which allow clinicians to cover some of the costs of moving to a new payment model, including expanding care teams.
Medicare Part D will cover certain over-the-counter products when prescribed by a clinician, and when it does, the program pays far more for these drugs, according to a recent study. Researchers at Johns Hopkins identified 22 drugs that are available both over-the-counter and via prescription; in 2020, Medicare paid out claims for 20 of those therapies. ...
California became the first state on Monday to offer comprehensive health insurance to all undocumented immigrants, a plan expected to expand to roughly 700,000 residents living in the Golden State.
Six months after the state restarted its health insurance eligibility process, more than 835,000 people who had their Medi-Cal terminated between June and October lost that coverage because of incomplete or missing paperwork.
While its merger with Humana may have fallen through for now, Cigna is attracting plenty of interest for the rumored sale of its Medicare Advantage business, Bloomberg reported. Sources close to the matter told the outlet that Health Care Service Corp. and Elevance Health are “competing” to scoop up the MA segment. Cigna is expecting ...
Milagro, a Peruvian immigrant in Riverside County, California, has had spotty access to health care in the two decades she’s been in this country. The 48-year-old, who works as the office manager at a nonprofit, can get emergency care through a narrow set of benefits the state makes available to immigrants without legal residency. And ...
A House vote on transparency regulations in healthcare could occur next week, potentially having substantial ramifications on how PBMs and hospitals operate.
The House Energy and Commerce Committee advanced 19 pieces of legislation Dec. 7, including bills aimed at increasing Medicare Advantage transparency. Three Medicare-related bills to note
A bipartisan group of representatives has introduced a bill into the House that would undo a 2024 physician pay cut finalized last month by the Biden administration. The 2024 Medicare Physician Fee Schedule final rule included a decrease in the conversion factor, which is used to calculate Medicare payments to doctors, that translated to a 3.37% pay decrease ...
Nearly two years into Gov. Gavin Newsom’s $12 billion experiment to transform California’s Medicaid program into a social services provider for the state’s most vulnerable residents, the institutions tasked with providing the new services aren’t effectively doing so, according to a survey released Tuesday. As part of the ambitious five-year initiative, called CalAIM, the state is supposed to offer ...