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.
It’s important to be on the lookout for scams every day of the year, but during Medicare Fraud Prevention Week June 3-9, Blue Shield of California warns its Medicare beneficiaries about scammers who want their personal, financial, and health plan information. Healthcare fraud in the U.S. is an enormous, expensive problem — costing up to $300 billion, according to the National Health Care Anti-Fraud Association. ...
Facing the wrath of upset investors following its first quarter earnings, CVS Health has promised to value margins over members going forward. First apologizing for last quarter’s earnings, which were plagued by higher-than-expected Medicare Advantage (MA) utilization, CFO Thomas Cowhey told the Bank of America Securities 2024 Health Care Conference crowd that CVS remains a big ...
More than 20% of Medicare Advantage patients could be affected by the rule, report finds.
Medicare Advantage plans have come under fire for upcoding that can increase the payouts they receive, and regulators point to health risk assessments as a likely culprit in this increase in coding intensity.
The gap between insurance plans and Medicare's payments to hospitals for inpatient and outpatient services widened over the course of just a couple of years, a new study from RAND Corporation finds.
For much of his young life, Jorge Sanchez regularly gasped for air, at times coughing so violently that he’d almost throw up. His mother whisked him to the emergency room late at night and slept with him to make sure he didn’t stop breathing. “He’s had these problems since he was born, and I couldn’t ...
More than half of all fee-for-service Medicare enrollees without any additional coverage chose a Medicare Supplement plan in 2021.
Healthcare and drug industry groups on Wednesday urged a U.S. appeals court to revive their challenge to a law requiring manufacturers to negotiate the prices of some drugs with the U.S government’s Medicare health insurance program or pay heavy penalties. Pharmaceutical Research and Manufacturers of America (PhRMA), the Global Colon Cancer Association and the National ...
CVS Health missed first-quarter expectations and chopped its 2024 outlook more than a dollar below Wall Street’s forecast. Shares of the health care giant plunged Wednesday after the company said it was still struggling with rising costs from care use in its Medicare Advantage business. Company leaders told analysts they were still dealing with rising use ...
Caregivers for older adults and people with disabilities could see a bump in their wages in the coming years, thanks to a forthcoming rule by the Centers for Medicare and Medicaid Services. The new rule brings sweeping changes to a bevy of Medicaid programs throughout the country, including fee-for-service and managed care delivery systems. One ...