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.

Nevada Moves To Shift Medicaid Services To Statewide Managed Care

Through a budget committee vote in May, state lawmakers reversed Gov. Joe Lombardo’s proposed cuts to the state-run public health insurance option popularly called the “public option” — a measure passed during the 2021 legislative session that Lombardo called “bullshit” on the campaign trail. But as part of that meeting, in a move that went ...

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Progressives Reintroduce ‘Medicare For All’ Bill

Key progressives in the House and Senate have revived the fight in Congress over "Medicare for All," a single-payer health system based on the Medicare program.

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Senate Scrutinizes MA Payment Denials, Including Use Of Algorithms

Medicare Advantage plans’ use of third-party algorithms for coverage determinations is facing some scrutiny in the Senate. Lawmakers in a Wednesday hearing argued something must be done to pare back burdensome prior authorization requirements allowing payers to delay or deny medical care that would be covered under traditional Medicare — including the use of artificial intelligence ...

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Ozempic Could Cost Medicare An Extra $26.8B Per Year If Coverage Were Expanded: Analysis

Patient demand for GLP-1 weight loss drugs is continuing to grow, and, if Medicare were to expand coverage to meet that demand, it could cost the program billions each year, according to a new analysis. Traditional Medicare does not currently cover these drugs, which include brand names like Novo Nordisk’s Ozempic and Wegovy, for weight loss. ...

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Medicaid Unwinding And The Impact On Group And Individual Health Insurance Markets

The Families First Coronavirus Response Act (FFCRA), signed into law in March 2020, created the first major lifeline for Americans during the onset of the COVID-19 pandemic. It particularly addressed the immediate needs of working Americans who had suddenly lost their paychecks and/or their jobs – and their subsequent eligibilities for health insurance. Now that ...

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Medicare Spending Could Increase $2 To $5 Billion If Coverage Expands For Lecanemab

Medicare annual spending on lecanemab's medication costs alone would place it among the most expensive Part B medications.

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Drugmakers Set Strategy For Legal Fight Against US Pricing Regulation

Some of the world’s biggest drugmakers are laying legal groundwork to fight the U.S. plan to negotiate drug prices for its Medicare health coverage, including the argument that a ban against speaking about these talks violates constitutional rights, according to six industry sources. The Biden Administration’s signature drug pricing reform, part of the Inflation Reduction ...

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First Wave of Nevada Medicaid Redeterminations Happening Now

As the state unwinds from the federal public health emergency, the Division of Welfare and Supportive Services (DWSS)  has begun the reevaluation of all Medicaid enrollments for the first time since 2020 during which you may lose coverage under Medicaid. In April, the first wave of recipients received their renewal packets in the mail. Those who ...

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Expanded Hospital Tax Could Boost Medicaid Rates, Fund Behavioral Health Services

Nevada’s lack of state-supported services for child mental health issues has been described as a “crisis” — underscored by a federal investigation last year revealing that the state’s lack of adequate treatment and services to children and youth with behavioral health disabilities likely violated federal law.

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OIG Finds $580 Million In Improper Psychotherapy Medicare Payments

The popularity and utility of telehealth has made it a more common form of healthcare delivery since the start of the COVID-19 pandemic, and telepsychiatry is one of the most used applications for the remote care technology. But the Department of Health and Human Services’ Office of the Inspector General has found that an estimated $580 million ...

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