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.
The Biden administration issued a final rule that seeks to make it easier for beneficiaries to enroll in Medicare and curb delays in getting coverage. The final rule, released Friday by the Centers for Medicare & Medicaid Services (CMS), would expand the number of special enrollment periods (SEPs) to let beneficiaries change their coverage outside ...
As 2023 annual open enrollment begins, CMS has received questions regarding changes, including the requirement related to recording calls between beneficiaries and Third-Party Marketing Organizations (TPMOs) and the requirements related to the TPMO disclaimer.
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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, ...
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 ...