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.

Google Rolls Out Search Features That Aim To Make It Easier To Sign Up For Medicaid, Medicare

The Google Search team has quietly rolled out multiple features for its search engine that aim to make it easier for users to access key information about obtaining Medicaid and Medicare benefits, as well as which doctors locally accept those types of coverage.

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Audits—Hidden Until Now—Reveal Millions In Medicare Advantage Overcharges

Newly released federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage health plans for seniors, with some plans overbilling the government more than $1,000 per patient a year on average. Summaries of the 90 audits, which examined billings from 2011 through 2013 and are the most recent reviews completed, were obtained ...

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Senate Bill Seeks To Improve Medicare Handbook Amid Spike In Marketing Complaints

New legislation seeks to improve the Medicare & You handbook in the latest attempt by Congress to scrutinize how Medicare Advantage plans are marketed to seniors. The legislation introduced Tuesday by Sens. Maggie Hassan, D-N.H., and Roger Marshall, R-Kan., would add new information to the handbook on health plan choices and supplemental insurance. It is ...

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4 Ways Medicaid Could Manage High-Price Drugs

Private payers can just say “no.” So can Medicare. Medicaid, however, must say “yes.” Medicaid must provide coverage for any medication approved by the Food and Drug Administration (FDA), even those medications approved under the FDA’s accelerated approval program (AAP), which are often very expensive medications that lack complete clinical data, according to a special commentary in ...

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Audits — Hidden Until Now — Reveal Millions in Medicare Advantage Overcharges

Newly released federal audits reveal widespread overcharges and other errors in payments to Medicare Advantage health plans for seniors, with some plans overbilling the government more than $1,000 per patient a year on average. Summaries of the 90 audits, which examined billings from 2011 through 2013 and are the most recent reviews completed, were obtained ...

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Medicare Plan Finder Likely Won’t Note New $35 Cap on Out-of-Pocket Insulin Costs

Congress approved in August a $35 cap on what seniors will pay for insulin as part of the Inflation Reduction Act, along with free vaccines and other Medicare improvements. But the change came too late to add to the Medicare plan finder, the online tool that helps beneficiaries sort through dozens of drug and medical plans for the best bargain.

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Hospital Groups Tell Lawmakers Looming Medicare Cuts 'Not Sustainable' As Officials Come Back

As Congress returns this week from a nearly monthlong recess, a collection of hospital groups is making sure resolution of a looming 4% cut to Medicare payments doesn’t slip through the cracks. The groups, led by the American Hospital Association and the Federation of American Hospitals, wrote to congressional leadership Monday calling for a waiver ...

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CMS Looking At Quality Metrics To Get ACA Exchange Plans Into Value-Based Care

Affordable Care Act (ACA) marketplace officials are hoping to get more plans into value-based care arrangements as regulators hope to not just build on getting people covered, according to federal officials. Officials with the Centers for Medicare & Medicaid Services (CMS) spoke Thursday at the Health Care Payment Learning and Action Network Summit on value-based ...

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What A Divided Congress Could Mean For Healthcare In The Next Year

In the current Congress, Democrats were able to expand Affordable Care Act (ACA) subsidies and introduce drug price reforms, but experts say there could still be some progress on areas of common ground if Republicans take one or both chambers of Congress.

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Medicare Drug Price Negotiation: Key Decisions To Reach A “Fair Price”

Government negotiation of Medicare drug prices—even for a small set of older, single-source drugs—is a remarkable policy development. But how exactly will the government do it? The Inflation Reduction Act (IRA), signed into law August 16, contains an 86-page blueprint laying out which drugs are on the table, implementation timelines, “factors” to be considered, and rules of engagement ...

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