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.

Insurers Set To Rake In $11.8B In Medicare Quality Bonus Payments For 2024

This year marked the expiration of certain pandemic-era policies that offered a temporary boost to insurers' star ratings, according to the report. However, the study notes that despite the decrease from 2023, bonus payments in 2024 are higher than any year from 2015 to 2022.

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U.S. Uninsured Rate Was Stable in 2023, Even as States’ Medicaid Purge Began

The proportion of Americans without health insurance remained stable in 2023, the Census Bureau reported Tuesday, close to the record low the Biden administration achieved in 2022 through expansions of public programs, including the Affordable Care Act. About 8% of Americans were uninsured, a statistically insignificant increase of just 0.1 percentage point from a year earlier. ...

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Medicare Advantage Customers Face Shrinking Pool of Insurers

Medicare Advantage plans have been successful in enrolling Medicare beneficiaries and delivering to those clients. Despite this, some insurers are downsizing their share of the market and hospitals are canceling or not renewing their contracts to serve plan members – leaving enrollees in the lurch. In recent months, Humana, CVS and some smaller insurers announced ...

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Hospitals Decry Proposed 2.6% Medicare Pay Bump, Urge CMS To Strike Maternal Health Requirements

Beyond their calls for increased outpatient payments, hospitals are urging the Biden administration to reconsider a plan for new care requirements that they say would “inadvertently reduce access to vital obstetrical services.” In July, the Centers for Medicare and Medicaid Services (CMS) released its Calendar Year 2025 Outpatient Prospective Payment System (OPPS) and ASC Payment ...

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Errors in Deloitte-Run Medicaid Systems Can Cost Millions and Take Years To Fix

Editor’s Note: California Medicaid (MediCal) enrollment is approximately 13 million and the Deloitte contract is over $500 million. Nevada Medicaid enrollment is approximately 845,504; the Deloitte contract amount data was unavailable. The computer systems run by the consulting giant Deloitte that millions of Americans rely on for Medicaid and other government benefits are prone to ...

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Big Pharma: Trump Vs. Harris Is A Showdown Between Two Industry Foes

Former President Donald Trump and Vice President Kamala Harris have a rare point of agreement in their otherwise bitter and divisive contest: It's up to the government to cut high U.S. drug prices.

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Medicare Agents Face Signs of Gloom

Agents are getting signs that the annual enrollment period for Medicare Advantage and Medicare Part D drug plans for 2025 will be as stormy as insurers and big brokers had predicted. Executives from CVS Health’s Aetna unit said during a conference call earlier this month that the company expected to let Medicare Advantage plan enrollment fall about 10% ...

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Biden Admin To Spend Billions To Blunt Spike In Medicare Drug Premiums

One of President Joe Biden’s signature domestic achievements is set to cause a significant spike in Medicare premiums for millions of Americans just ahead of the November election. Now, his administration is preparing to dole out billions of dollars to private insurance companies to blunt the impact of the increase.

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Post-Pandemic Disenrollment May Spell Budget Troubles For Nevada Medicaid, Lawmakers Warned

Nearly 300,000 people have been disenrolled from Nevada Medicaid following the end of a pandemic-era policy that kept people continuously enrolled, state lawmakers learned Thursday, and an additional 45,000 may lose coverage next month. Those numbers are “more than we ever anticipated,” Nevada Medicaid Administrator Stacie Weeks told legislators on the Interim Finance Committee, and ...

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White House Says Prescription Drug Deals Will Produce Billions In Savings for Taxpayers, Seniors

Taxpayers are expected to save billions after the Biden administration inked deals with pharmaceutical companies to knock down the lists prices for 10 of Medicare’s costliest drugs. But how much older Americans can expect to save when they fill a prescription at their local pharmacy remains unclear, since the list cost isn’t the final price people ...

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