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.
Breakthroughs in weight-loss medicine are presenting state Medicaid officials with what looks like a sure bet: Spend big now to cover the drugs and reap savings when diabetes, heart disease and cancer rates drop. States are hesitating to take it. The few states that have decided to cover drugs like Ozempic and Wegovy to help ...
Healthcare politics and investing might as well be living in alternate universes. President Trump and some Republicans have been describing Obamacare as a gravy train for insurers. Trump’s latest broadside slammed “big, fat, rich insurance companies who have made trillions,” and he urged Congress to send healthcare subsidies directly to patients instead. Wall Street sees ...
The stopgap spending bill signed Nov. 12 by President Donald Trump halts a looming $536 billion Medicare cut and temporarily extends several key health programs, avoiding deeper disruptions from the now-ended government shutdown. The legislation keeps most federal agencies funded through Jan. 30 and fully funds the Department of Agriculture, the FDA and the VA ...
Medicare beneficiaries are set to see their Part B premiums rise significantly next year, according to an announcement from the Trump administration. The Centers for Medicare & Medicaid Services (CMS) revealed late Friday that total monthly premiums for Part B will be $202.90. By comparison, the premium for 2025 was $185. In addition, the deductible in Part ...
Despite their inclusion on a “Hospital Crisis Watch” list, Battle Mountain General Hospital and Humboldt General Hospital are not at immediate risk of closing after federal health care spending cuts this summer. Both were included on Protect Our Care’s list of at-risk rural hospitals, defined as either being in the top 10% Medicaid payer mix ...
The Trump administration is rolling out a new model that aims to bring most-favored nation pricing to the Medicaid space. The Centers for Medicare & Medicaid Services announced late Thursday the launch of the GENErating cost Reductions for U.S. Medicaid (GENEROUS) model, under which participating state Medicaid programs will be able to purchase certain drugs at ...
The Centers for Medicare & Medicaid Services (CMS) has issued new guidance allowing Medicare Advantage plans to maintain coverage of certain telehealth services that technically expired when federal telehealth authorities lapsed on October 1, 2025. Under the announcement, CMS will temporarily waive the prohibition on mid-year benefit changes to permit plans to continue offering these ...
Medicare has locked in a controversial pay cut for specialty doctors next year, normalizing reimbursement between specialists and primary care doctors and curbing the influence of a powerful physician association in setting rates. The CMS finalized the 2026 Medicare physician fee schedule on Friday. The massive payment rule includes a so-called “efficiency adjustment,” which reduces ...
Two leading organizations representing Medicaid managed care plans are offering several key suggestions to the Trump administration for managing the rollout of work requirements in the program. In the letter (PDF), experts at Medicaid Health Plans of America (MHPA) and the Association for Community-Affiliated Plans (ACAP) urged the Centers for Medicare & Medicaid Services (CMS) to allow ...
Luca-Amine Hadir was 4 days old when his parents raced him to the ER. His mother, Jill McDonald, had wanted her child to have a gentle transition into the world, and Luca’s first four days were just that. He was born at home in San Francisco’s Bernal Heights neighborhood, in spring 2020 — Jill, now ...