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.

Biden Budget Plan Prioritizes Mental Health, Public Health

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.

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New Normal For Health Care Spending

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 ...

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Accelerated Health Spending Expected Through 2030 As COVID Impacts Lessen

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 ...

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Hospital, Long-Term Care Groups Again Petition Becerra To Extend COVID-19 Public Health Emergency

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 ...

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KFF: $35 Monthly Insulin Cost Cap Could Benefit 1 In 4 Americans In Individual, Small Group Plans

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 ...

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Pandemic Hastens Shift Away From Hospital Inpatient Care, Moody’s Reports

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 ...

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Becerra: HHS Wants To Get ‘Money’s Worth’ On Medicare Advantage, Will Look Into Coding Practices

The Department of Health and Human Services (HHS) is examining risk adjustment tactics that have led to overpayments to some Medicare Advantage plans, Secretary Xavier Becerra told reporters Friday. Becerra said the agency has seen evidence of charges going beyond what would be necessary for MA plans using tactics such as up-coding. The remarks come ...

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Congress To Grant 5-Month Extension For Pandemic Telehealth Flexibilities With Omnibus Bill

The extension would leave the flexibilities in place for 151 days after the end of the federal public health emergency, which currently expires in April but is expected to be extended into July.

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Listen: An Unsettling Investigation Into the Closure of a Chain of Pain Clinics

Last spring, Lags Medical Centers, a sprawling chain of pain clinics serving more than 20,000 patients in California, abruptly shuttered amid a cloaked state investigation into “credible allegations of fraud.” Tens of thousands of patients were left scrambling for care, most of them low-income Californians covered by state and federal insurance programs. Many have struggled ...

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Want Vulnerable Californians to Have Healthier Pregnancies? Doulas Say the State Must Pay Up.

This was supposed to be the year that low-income Californians could hire a doula to guide them through pregnancy and advocate for them in the hospital.

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