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.

Hospital, Physician Groups Push Back On CMS Payment Rules As COVID-19 Assistance Dwindles

Several provider groups are slamming recent payment rules offering small price hikes for 2023, as COVID-19 relief in place for more than two years erodes. Groups are clamoring for regulators to boost payments in the proposed 2023 Physician Fee Schedule and Outpatient Prospective Payment System (OPPS) rules. Providers say that added pressures of labor shortages, inflation and renewed surges ...

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Dems Want To Tax High Earners To Protect Medicare Solvency

Senate Democrats want to boost taxes on some high earners and use the money to extend the solvency of Medicare, the latest step in the party’s election-year attempt to craft a scaled-back version of the economic package that collapsed last year

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Medi-Cal’s Reliance on Prisoners to Make Cheaper Eyeglasses Proves Shortsighted

To dodge hefty costs for eyewear, California’s health insurance program for low-income people, Medi-Cal, has an innovative strategy: It contracts exclusively with the state’s prisons, and inmates make glasses for its beneficiaries. But the partnership that began more than 30 years ago has fractured. Medi-Cal enrollees, many of whom are children, and their eye care ...

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Despite Pandemic, Children’s Uninsurance Rates Declined In 2021

While COVID-19 job losses may have led to uninsurance for some Americans, it doesn’t appear that children’s insurance rates were negatively impacted. In fact, new research suggests that children’s uninsurance rates actually fell between 2019 and 2021. The report, published by Urban Institute this week, looks at survey data from the National Health Interview Survey (NHIS) and ...

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Seeking to Kick-Start Biden’s Agenda, Schumer Unveils a Bill for Medicare Drug Price Negotiations

Democratic senators on Wednesday took a formal step toward reviving President Joe Biden’s economic agenda, starting with a measure to let Medicare negotiate prices with drugmakers and to curb rising drug costs more broadly. A similar proposal died in December when Sen. Joe Manchin (D-W.Va.) decided to oppose Biden’s $1.9 trillion Build Back Better bill, ...

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Feds Want a Policy That Advocates Say Would Let Hospitals Off the Hook for Covid-Era Lapses

The Centers for Medicare & Medicaid Services is responding to the chaos of the covid-19 pandemic by proposing to hide from the public a rating that lets consumers compare hospitals’ safety records and to waive approximately $350 million in financial penalties for roughly 750 hospitals with the worst patient-safety track records. CMS’ chief medical officer, Dr. Lee Fleisher, said those ...

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CMMI Finds Implicit Bias In 3 Major Payment Models

An analysis of three existing payment models found certain screening tools and other designs led to some Medicare beneficiaries being excluded and prompted the creation of a new guide on how to root out bias in models. Researchers with the Center for Medicare and Medicaid Innovation (CMMI) outlined in a Health Affairs article troubling instances of implicit ...

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Government Watchdogs Attack Medicare Advantage For Denying Care And Overcharging

Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars every year, government watchdogs told a House panel Tuesday.

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Hospital Groups Decry New Round Of DSH Cuts In Latest Infrastructure Bill

Hospital groups are making a last-minute push to prevent Congress from including cuts to safety net hospitals in a massive $1.75 trillion infrastructure package.

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AHA Wants Congress To Pressure CMS To Reverse Updates For Inpatient Payment Rule

The American Hospital Association (AHA) is turning to lawmakers to pressure the Biden administration to change “woefully inadequate” payment rates proposed for next year. The AHA sent a letter Friday to congressional leaders surrounding the proposed Inpatient Prospective Payment Systems (IPPS) rule, which sets inpatient rates for next year. The hospital lobbying group charged that ...

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