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.

Here’s What You Need To Know About The Lower Costs, More Transparency Act

A House vote on transparency regulations in healthcare could occur next week, potentially having substantial ramifications on how PBMs and hospitals operate.

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Medicare Bills Pass House Committee: 3 Things To Know

The House Energy and Commerce Committee advanced 19 pieces of legislation Dec. 7, including bills aimed at increasing Medicare Advantage transparency. Three Medicare-related bills to note

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Bipartisan Reps Introduce Bill Canceling 2024’s 3.4% Medicare Pay Cut To Physicians

A bipartisan group of representatives has introduced a bill into the House that would undo a 2024 physician pay cut finalized last month by the Biden administration. The 2024 Medicare Physician Fee Schedule final rule included a decrease in the conversion factor, which is used to calculate Medicare payments to doctors, that translated to a 3.37% pay decrease ...

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California’s Ambitious Medicaid Experiment Gets Tripped Up in Implementation

Nearly two years into Gov. Gavin Newsom’s $12 billion experiment to transform California’s Medicaid program into a social services provider for the state’s most vulnerable residents, the institutions tasked with providing the new services aren’t effectively doing so, according to a survey released Tuesday. As part of the ambitious five-year initiative, called CalAIM, the state is supposed to offer ...

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As Medicare Advantage Market Share Grows, So Does Criticism Of Companies Selling The Plans

The enrollment period for Medicare ends on Dec. 7 — and many people across the nation are deciding about supplementing Medicare with Medicare Advantage plans. Medicare Advantage plans, which are plans offered through private insurer companies that the federal government contracts with, are advertised as a solution to original Medicare’s limited scope in coverage, but have ...

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CMS Proposes Rule To Tighten Medicare Advantage Marketing

The proposed rule will also purportedly improve access to behavioral healthcare and make prior authorization more transparent.

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No One’s Promising You Can Keep Your Doctor Anymore

President Barack Obama famously told Americans they could keep their doctors. At the rate things are going, it won’t be long before many Americans don’t have one in the first place — at least not the way they’re used to. The math is simple: Medical schools just aren’t churning out doctors fast enough to keep ...

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Retirees Face Significantly Higher Medicare Part D Prescription Drug Premiums In 2024. What To Know

A new law is poised to cap seniors’ prescription drug costs covered under Medicare, starting in 2025. But retirees may be in for a shock next year — significantly higher Medicare Part D premiums for prescription drug coverage. The cost of the average premiums will rise between 42% and 57% in 2024 compared to 2023 in five states with the ...

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Big Changes Coming To Medi-Cal, The State’s Health Plan For 40% Of Californians

Starting Jan. 1, two groups of people that had not been eligible for full-scale Medi-Cal will gain access: low-income adults ages 26-49 and some people who are disabled or older than 64. On the other hand, some current Medi-Cal enrollees will lose coverage.

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Beyond Insulin: Medi-Cal Expands Patient Access to Diabetes Supplies

June Voros sprang from her couch as a high-pitched beep warned her that she needed a quick dose of sugar. Her blood sugar was plummeting, and the beep came from a continuous glucose monitor attached to her abdomen. The small but powerful device alerts Voros when her blood sugar is dangerously high or low. “My blood sugar ...

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