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.

Congress Reaches Major Health Policy Deal On Medicare, Medicaid, And Pandemic Preparedness

Leaders in Congress have reached a sweeping deal to ease Medicare pay cuts to doctors, make major changes to post-pandemic Medicaid policy, and to help prepare for future pandemics.

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CMS Proposes Cap On Nonstandard ACA Plans, Network Adequacy Standard Changes For 2024

The Biden administration wants to limit to two the number of nonstandardized Affordable Care Act (ACA) exchange plans an insurer can offer on HealthCare.gov in 2024 as part of an effort to make it easier for consumers to pick a plan. The Centers for Medicare & Medicaid Services (CMS) released Monday the proposed Notice of ...

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CMS Proposes New Medicare Advantage And Part D Reforms On Prior Authorization, Marketing

The Biden administration released a proposal to streamline Medicare Advantage (MA) and Part D plan prior authorization and add health equity requirements to star ratings. The Centers for Medicare & Medicaid Services (CMS) released a proposed rule Wednesday outlining policies for MA and Part D plans for the 2024 coverage year and implementing drug price provisions in ...

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Biden Administration Proposes Crackdown On Scam Medicare Ads

The Biden administration on Wednesday proposed a ban on misleading ads for Medicare Advantage plans that have targeted older Americans and, in some cases, convinced them to sign up for plans that don’t cover their doctors or prescriptions.

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Health Insurance is Helping Cool Inflation. But ‘It’s Not a Very Good Reflection’ of What People Pay, Cautions Economist

In an environment of high inflation, health insurance costs are doing the opposite: They’ve begun to deflate, and are poised to continue dropping each month until fall 2023, economists predict. Health insurance prices fell by 4% in October and 4.3% in November, according to the consumer price index, a key measure of inflation. By comparison, the ...

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MedPAC Wants Pay Boost For Docs And Hospitals

MedPAC wants Congress to increase hospitals and clinicians’ 2o24 Medicare payment rates. Why it matters: If Congress opts not to follow the recommendations, CMS has to make payment updates according to current law — setting up another year of providers running to lawmakers for relief from Medicare cuts after the fact. * Commissioners hashed out draft payment recommendations ...

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Google Rolls Out Search Features That Aim To Make It Easier To Sign Up For Medicaid, Medicare

The Google Search team has quietly rolled out multiple features for its search engine that aim to make it easier for users to access key information about obtaining Medicaid and Medicare benefits, as well as which doctors locally accept those types of coverage.

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Audits—Hidden Until Now—Reveal Millions In Medicare Advantage Overcharges

Newly released federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage health plans for seniors, with some plans overbilling the government more than $1,000 per patient a year on average. Summaries of the 90 audits, which examined billings from 2011 through 2013 and are the most recent reviews completed, were obtained ...

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Senate Bill Seeks To Improve Medicare Handbook Amid Spike In Marketing Complaints

New legislation seeks to improve the Medicare & You handbook in the latest attempt by Congress to scrutinize how Medicare Advantage plans are marketed to seniors. The legislation introduced Tuesday by Sens. Maggie Hassan, D-N.H., and Roger Marshall, R-Kan., would add new information to the handbook on health plan choices and supplemental insurance. It is ...

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4 Ways Medicaid Could Manage High-Price Drugs

Private payers can just say “no.” So can Medicare. Medicaid, however, must say “yes.” Medicaid must provide coverage for any medication approved by the Food and Drug Administration (FDA), even those medications approved under the FDA’s accelerated approval program (AAP), which are often very expensive medications that lack complete clinical data, according to a special commentary in ...

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