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.
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 ...
Congress approved in August a $35 cap on what seniors will pay for insulin as part of the Inflation Reduction Act, along with free vaccines and other Medicare improvements. But the change came too late to add to the Medicare plan finder, the online tool that helps beneficiaries sort through dozens of drug and medical plans for the best bargain.
As Congress returns this week from a nearly monthlong recess, a collection of hospital groups is making sure resolution of a looming 4% cut to Medicare payments doesn’t slip through the cracks. The groups, led by the American Hospital Association and the Federation of American Hospitals, wrote to congressional leadership Monday calling for a waiver ...
Affordable Care Act (ACA) marketplace officials are hoping to get more plans into value-based care arrangements as regulators hope to not just build on getting people covered, according to federal officials. Officials with the Centers for Medicare & Medicaid Services (CMS) spoke Thursday at the Health Care Payment Learning and Action Network Summit on value-based ...
In the current Congress, Democrats were able to expand Affordable Care Act (ACA) subsidies and introduce drug price reforms, but experts say there could still be some progress on areas of common ground if Republicans take one or both chambers of Congress.
Government negotiation of Medicare drug prices—even for a small set of older, single-source drugs—is a remarkable policy development. But how exactly will the government do it? The Inflation Reduction Act (IRA), signed into law August 16, contains an 86-page blueprint laying out which drugs are on the table, implementation timelines, “factors” to be considered, and rules of engagement ...
The night before his scheduled cataract surgery last November, Bob Miller’s eye doctor informed him the operation would be delayed because his insurer refused to pay. Miller’s Aetna Medicare plan covered a surgery just a few weeks before on his right eye. Without the surgery on his left eye, the 73-year-old residential painting contractor couldn’t ...
Healthcare insurance premiums remained stable in 2022 compared to 2021 but might surge next year because of inflation and the demands of employees for better mental health coverage, according to the Kaiser Family Foundation’s “2022 Employer Health Benefits Survey.” “Demand” might be the right word, given the competition among employers for workers in a tight ...
For 23 years, the private ambulance industry in California had gone without an increase in the base rate the state pays it to transport Medicaid enrollees. At the start of the year, it asked the state legislature to more than triple the rate, from around $110 to $350 per ride. The request went unheeded. In September, American ...
The federal government has eased its annual punishments for hospitals with higher-than-expected readmission rates in an acknowledgment of the upheaval the covid-19 pandemic has caused, resulting in the lightest penalties since 2014. The Hospital Readmissions Reduction Program has been a mainstay of Medicare’s hospital payment system since it began in 2012. Created by the Affordable ...