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.
AHIP, the top lobbying organization for commercial insurers, is warning the feds that provisions in its proposed rule governing the Affordable Care Act’s exchanges for 2023 could “undermine” the growing stability there. For instance, the group says in comments (PDF) submitted late Thursday that potential changes to requirements for essential health benefits would limit the ability for ...
Regional healthcare markets across the country have experienced significant divergence in commercial-to-Medicare price ratios between 2012 and 2019, causing insurers to pay wildly different rates to hospital systems. In areas like Chico, California and Tacoma, Washington, private payers saw hospital price ratios increase by over 100 percentage points. On the other end of the spectrum, ...
Private insurers who administer Medicare Advantage plans can expect a 5% average increase in federal payments next year — half a percentage point above what the Biden administration proposed in February. Why it matters: The pay bump in the controversial program marks a big win for insurers like UnitedHealth Group and Humana and doused speculation the ...
Amid worries that the latest coronavirus variant could spark another rise in cases, Medicare announced Monday that millions of enrollees will finally have access to free over-the-counter COVID-19 tests at drug stores. More than 59 million people with Medicare’s “Part B” outpatient coverage will be able to get up to eight free at-home tests per month, or ...
The Health and Human Services Department would get a 26.8% spending boost in fiscal 2023 under a budget proposal the White House issued Monday. The budget plan outlines President Joe Biden's health priorities, which include improving public health infrastructure, advancing mental healthcare and making maternal health more equitable.
U.S. health care spending is likely to grow at about the rate of inflation over the rest of the decade after the pandemic fueled a nearly 10% jump between 2019 and 2020, federal experts said Monday. The big picture: The CMS actuaries’ projections in Health Affairs came with plenty of caveats. But if trends hold, out-of-pocket spending is ...
National health spending is expected to grow 4.9% annually over the next three years and 5.3% from 2025 to 2030, according to the latest estimates from the Centers for Medicare & Medicaid Services (CMS). This is expected to be driven in part by higher drug price growth and new pharmaceutical launches. National health spending growth is expected ...
Industry provider groups are again asking Department of Health and Human Services (HHS) Secretary Xavier Becerra to extend the government’s COVID-19 public health emergency, which is set to expire April 16. In a letter sent Monday, 10 national hospital and health system organizations acknowledged growing interest in ending the PHE due to the country’s ongoing ...
A $35-a-month cap on out-of-pocket insulin costs could benefit more than 1 in 4 Americans on the individual and small group markets and 1 in 5 in large employer-sponsored plans, a new analysis found. The analysis, published Thursday by the Kaiser Family Foundation, comes as Democrats are working to renew efforts to install a $35 ...
Dive Brief: * The long-term shift from hospital-based care toward more treatment delivered in the home and ambulatory centers picked up pace during the COVID-19 pandemic and is expected to continue to gain momentum, pressuring revenue growth and margins in the hospital sector, according to new research from Moody’s Investors Service. * Reimbursement changes, risk-sharing, investment ...