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.

Lawsuits, Challenges And Debates: Where California's Controversial Medicaid Contract Process Stands

California’s first-ever Medicaid managed contract procurements are a major shakeup in the state’s Medi-Cal system, which has over 12 million enrollees, or a third of California’s population. Millions of residents will switch plans as a result of the changes, and a lengthy road of appeals and legal battles could lay ahead. California selected the intended ...

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After Congress Fails to Add Dental Coverage, Medicare Weighs Limited Benefit Expansion

Proposed changes in Medicare rules could soon pave the way for a significant expansion in Medicare-covered dental services, while falling short of the comprehensive benefits that many Democratic lawmakers have advocated. That’s because, under current law, Medicare can pay for limited dental care only if it is medically necessary to safely treat another covered medical ...

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Hospitals Said They Lost Money on Medicare Patients. Some Made Millions, a State Report Finds.

Atrium Health, the largest hospital system in North Carolina, has declared publicly that in 2019 it provided $640 million in services to Medicare patients that were never paid for, by far the largest “community benefit” it provided that year. Like other nonprofit hospitals around the nation, Atrium logs losses on the federal health insurance program ...

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New Biden Order Wants CMMI To Test Payment Models That Tackle High Drug Prices

President Joe Biden is calling for new payment and delivery models that will lower drug prices in a new executive order. The order released Friday calls on the Department of Health and Human Services to craft a report outlining the payment models that will test how to improve access to innovative drugs and lower costs for those ...

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After Congress Fails to Add Dental Coverage, Medicare Weighs Limited Benefit Expansion

Proposed changes in Medicare rules could soon pave the way for a significant expansion in Medicare-covered dental services, while falling short of the comprehensive benefits that many Democratic lawmakers have advocated. That’s because, under current law, Medicare can pay for limited dental care only if it is medically necessary to safely treat another covered medical ...

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The Great Unwinding: The Opportunity For Brokers

The COVID-19 public health emergency is expected to end early in 2023, which means that next year will be marked by millions of Americans having to be determined eligible to continue to receive Medicaid benefits. According to an analysis by the Kaiser Family Foundation, an estimated 5.3 million to 14.2 million Americans could lose their Medicaid coverage ...

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Pandemic, Aging Population Lead To Historic High Health Coverage Rates

The COVID-19 pandemic combined with the Affordable Care Act resulted in a historic high percentage of Americans having health coverage. What’s behind this historic high? Two experts from Manatt Health looked at trends in access to care through Medicare, Medicaid and the commercial health insurance market at a webinar on Thursday. Between 2011 and 2021, ...

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Some Seniors Make This Costly Medicare Enrollment Mistake. A Bipartisan Bill Looks To Fix It

A bipartisan bill in the House aims to fix a costly enrollment mistake that some older adults make when they transition to Medicare from an employer-based health plan. Under current rules, workers age 65 or older who leave their job but keep their company’s health insurance as allowed under federal law — the Consolidated Omnibus ...

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Nursing Home Surprise: Advantage Plans May Shorten Stays to Less Time Than Medicare Covers

Health care providers, nursing home representatives, and advocates for residents say Medicare Advantage plans are increasingly ending members’ coverage for nursing home and rehabilitation services before patients are healthy enough to go home.

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Health Plan Shake-Up Could Disrupt Coverage for Low-Income Californians

Almost 2 million of California’s poorest and most medically fragile residents may have to switch health insurers as a result of a new strategy by the state to improve care in its Medicaid program.

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