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.
An analysis of three existing payment models found certain screening tools and other designs led to some Medicare beneficiaries being excluded and prompted the creation of a new guide on how to root out bias in models. Researchers with the Center for Medicare and Medicaid Innovation (CMMI) outlined in a Health Affairs article troubling instances of implicit ...
Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars every year, government watchdogs told a House panel Tuesday.
Hospital groups are making a last-minute push to prevent Congress from including cuts to safety net hospitals in a massive $1.75 trillion infrastructure package.
The American Hospital Association (AHA) is turning to lawmakers to pressure the Biden administration to change “woefully inadequate” payment rates proposed for next year. The AHA sent a letter Friday to congressional leaders surrounding the proposed Inpatient Prospective Payment Systems (IPPS) rule, which sets inpatient rates for next year. The hospital lobbying group charged that ...
Top senators unveiled a bipartisan bill Wednesday that aims to curb the high cost of insulin, a lifesaving drug that some Americans have struggled to pay for as prices of the medicine have soared. The legislation from Sens. Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine) is the product of months of work to forge a compromise. But ...
The Supreme Court ruled 7-2 Tuesday that a group health plan in Ohio didn’t violate federal law by offering limited coverage for outpatient dialysis in a case brought by DaVita, one of the largest dialysis providers in the United States. The court sided with Marietta Memorial Hospital’s employee health plan, with Justice Brett M. Kavanaugh writing in ...
Medicare could have saved nearly $4 billion in 2020 by purchasing generic drugs at the same prices offered by Cost Plus Drug Company, Cuban's online pharmacy that launched this year, according to a study published Monday in the journal Annals of Internal Medicine.
The American Hospital Association has urged the Centers for Medicare and Medicaid Services to extend enforcement discretion for the No Surprises Act regulatory requirement that healthcare providers exchange certain information to create a good faith estimate for uninsured and self-pay patients – until the agency identifies, and providers can implement, a standard, automated way to exchange the ...
Hospital groups and providers are demanding the Biden administration increase a proposed 3.2% pay bump for inpatient payments to facilities, arguing inflation and a staffing crisis are still hitting them hard. The Centers for Medicare & Medicaid Services (CMS) proposed the pay bump for fiscal year 2023 as part of the Inpatient Prospective Payment System ...
A recent survey of Medicare Advantage enrollees found 13% had a claim or pre-authorization request denied as the program has gotten scrutiny over its prior authorization practices. The survey, released Monday by the online insurance marketplace eHealth, also found that 67% of respondents chose MA over Medigap due to concerns over its affordability. The MA ...