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.

It’s ‘Telehealth vs. No Care’: Doctors Say Congress Risks Leaving Patients Vulnerable

The $1.7 trillion spending package Congress passed in December included a two-year extension of key telehealth provisions, such as coverage for Medicare beneficiaries to have phone or video medical appointments at home. But it also signaled political reluctance to make the payment changes permanent, requiring federal regulators to study how Medicare enrollees use telehealth.

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Why Drugmakers Have Raised Prices On Nearly 1,000 Drugs So Far This Year

With pharmaceutical companies hiking prices on nearly 1,000 drugs in January, some consumers might experience sticker shock next time they pick up prescriptions. The price increases come as a new federal law requires companies to pay Medicare a rebate if they increase prices above the rate of inflation. Other Inflation Reduction Act provisions — such as capping Medicare recipients’ out-of-pocket ...

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Biden Administration Seeks To Recoup $4.7 Billion From Medicare Advantage Plans

The Biden administration on Monday finalized an oft-delayed plan to step up audits of Medicare Advantage insurers in order to identify and recover overpayments. Why it matters: Studies and audits have identified billions of dollars of excess payments to health plans that weren’t supported by patients’ medical records, but federal officials in the past backed off many ...

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House GOP Study Group Is Proposing Changes To Medicare. Here’s What You Need To Know

As congressional lawmakers in the House slog through the early stages of negotiating over the debt ceiling — the amount of money the U.S. government can borrow — there’s been concern that those discussions could include spending cuts to Medicare. However, House Speaker Kevin McCarthy, R-Calif., has now made assurances that Medicare is off-limits during these negotiations (as is Social ...

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The December Omnibus Bill’s Little Secret: It Was Also A Giant Health Bill

The giant spending bill passed by Congress last month kept the government open. But it also quietly rewrote huge areas of health policy: Hundreds of pages of legislation were devoted to new health care programs.

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What The Inflation Reduction Act’s Reforms To Medicare Part D Mean For Prescription Drug Prices

Last year, President Joe Biden signed into law the Inflation Reduction Act (IRA), setting into motion a series of changes to the way that Medicare and its beneficiaries pay for prescription drugs. Much has been written about the act’s individual provisions, but little has been said about how they fit together as a whole. In fact, these seemingly standalone ...

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Spending Bill Extends Telehealth Coverage For HDHPs Through 2024

Now, it’s been extended a second time, with the most recent government spending bill reinstating the provision through at least December 31, 2024, according to the Society of Human Resource Management.

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Employer-Sponsored Coverage Flatlined Even As Unemployment Rate Shrunk: Study

While unemployment rates have declined since the early days of the pandemic, enrollment in employer-sponsored coverage has remained largely stagnant, a new study shows.

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Key Trends For Payers And Providers In 2023

Providers will be forced to navigate a challenging year as they try to rein in expense growth fueled by pandemic-driven labor shortages. This year’s outlook for a large chunk of the healthcare sector remains negative as inflation and pricier labor create difficult operating conditions for nonprofit providers, Moody’s Investor Service said. As a result, health systems ...

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Becerra Renews COVID-19 Public Health Emergency Another 90 Days, Possibly For Last Time

Department of Health and Human Services (HHS) Secretary Xavier Becerra renewed Wednesday the COVID-19 public health emergency (PHE) for another 90 days, extending with it key waivers and regulatory flexibilities. The PHE—which has been in place since Jan. 31, 2020—will now run for another 90 days. Becerra has agreed, though, to give stakeholders a 60-day ...

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