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.
Dive Brief: The AHIP insurance lobby blasted the Biden administration for finalizing a rule that seeks to claw back millions of dollars from health insurers through Medicare Advantage audits that will apply retroactively to payments beginning in 2018. AHIP called the final rule “unlawful” and “fatally flawed” in a Monday statement following the rule’s release. The lobby ...
The Biden administration is proposing to increase Medicare Advantage (MA) and Part D plan payments by 1.03% for 2024 amid other changes to the programs’ risk adjustment model. The Centers for Medicare & Medicaid Services (CMS) released the advance notice of methodological changes for MA capitation rates and payment policies for MA and Part D. ...
California’s decision last month to cancel the results of a long-planned bidding competition among commercial health plans in its Medicaid program has some industry insiders and consumer advocates wondering whether the state can stand up to insurers and force improvements in care for millions of low-income beneficiaries.
Speaker Kevin McCarthy (R-Calif.) said on Thursday that House Republicans will not target Medicare or Social Security in their negotiations over the debt ceiling.
The $1.7 trillion spending package Congress passed in December included a two-year extension of key telehealth provisions, such as coverage for Medicare beneficiaries to have phone or video medical appointments at home. But it also signaled political reluctance to make the payment changes permanent, requiring federal regulators to study how Medicare enrollees use telehealth.
With pharmaceutical companies hiking prices on nearly 1,000 drugs in January, some consumers might experience sticker shock next time they pick up prescriptions. The price increases come as a new federal law requires companies to pay Medicare a rebate if they increase prices above the rate of inflation. Other Inflation Reduction Act provisions — such as capping Medicare recipients’ out-of-pocket ...
The Biden administration on Monday finalized an oft-delayed plan to step up audits of Medicare Advantage insurers in order to identify and recover overpayments. Why it matters: Studies and audits have identified billions of dollars of excess payments to health plans that weren’t supported by patients’ medical records, but federal officials in the past backed off many ...
As congressional lawmakers in the House slog through the early stages of negotiating over the debt ceiling — the amount of money the U.S. government can borrow — there’s been concern that those discussions could include spending cuts to Medicare. However, House Speaker Kevin McCarthy, R-Calif., has now made assurances that Medicare is off-limits during these negotiations (as is Social ...
The giant spending bill passed by Congress last month kept the government open. But it also quietly rewrote huge areas of health policy: Hundreds of pages of legislation were devoted to new health care programs.
Last year, President Joe Biden signed into law the Inflation Reduction Act (IRA), setting into motion a series of changes to the way that Medicare and its beneficiaries pay for prescription drugs. Much has been written about the act’s individual provisions, but little has been said about how they fit together as a whole. In fact, these seemingly standalone ...