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.
Almost 2 million of California’s poorest and most medically fragile residents may have to switch health insurers as a result of a new strategy by the state to improve care in its Medicaid program.
The Inflation Reduction Act Aims To Lower Drug Costs — But Here’s How Big Pharma Could Get Around It
The Inflation Reduction Act is set to lower drug prices for millions of people in the U.S. — but experts fear pharmaceutical companies could exploit loopholes in the bill, ultimately keeping prescription costs high for many. The law takes aim at insulin costs, caps out-of-pocket spending for Medicare beneficiaries, and allows the federal government to ...
Medicare Advantage is better about coaxing seniors to get preventive healthcare while traditional Medicare lands its beneficiaries in higher quality hospitals, an analysis of more than 60 studies shows. “Enrollees in Medicare Advantage were more likely to get routine check-ups and immunizations, while those in traditional Medicare were more likely to receive care in the highest-rated ...
The U.S. House of Representatives unanimously passed legislation that would streamline the prior authorization (PA) process used for Medicare Advantage patients. The Improving Seniors’ Timely Access to Care Act, which has earned strong support from medical organizations, will move to the Senate for consideration. It already has strong bipartisan support there. The law proposes to make it ...
Employers (of any size) providing prescription drug coverage benefits must distribute an annual notice to all Medicare-eligible individuals by October 15th – including both employees and dependents.
Medicare is poised to renegotiate the prices of some of its most expensive drugs through a historic expansion of its power, which could reduce costs for many seniors as well as federal spending on its prescription drug plan. The changes are tucked inside a massive spending-and-tax bill in Congress that includes $433 billion in investments ...
The Biden administration needs to back off a massive overhaul to risk adjustment audits for Medicare Advantage (MA) plans, according to insurers that say the proposal unfairly targets prior audits dating back a decade. Insurer advocacy groups and providers submitted comments to a request for information on how to improve the MA program. Insurers turned ...
The Biden administration proposed new regulations aimed at overhauling the application and renewal processes for Medicaid and other government programs, including ensuring a beneficiary’s returned mail doesn’t automatically lead to coverage denials. The Centers for Medicare & Medicaid Services (CMS) released a proposed rule that makes changes to the enrollment process for Medicaid, Children’s Health Insurance Program ...
The Biden administration is investing $98.9 million in grant funding to 59 returning Navigator organizations that assist consumers in picking an Affordable Care Act (ACA) exchange plan.
Dive Brief: * About 17% of enrollees in Medicaid and the Children’s Health Insurance Program, or 15 million people, could lose their coverage when states resume regular eligibility checks once the COVID-19 public health emergency ends, HHS projected in a report from the Office of the Assistant Secretary for Planning and Evaluation. * Loss of eligibility will require ...