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.

Healthcare Priorities For The Next Congress

What kind of healthcare reforms can we expect from the 118th Congress? The outlook is a bit cloudy.

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California Awards Managed Care Contracts To Molina, Elevance Health And Others For 2024

California has awarded managed care plan contracts to five insurers to serve Medicaid beneficiaries across 21 counties in the state in 2024.

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OIG: CMS Needs To Help Drugmakers In Calculating Best Medicare Part B Prices

Drugmakers need more guidance from the Centers for Medicare & Medicaid Services (CMS) on how to calculate the best price for drugs sold on Medicare Part B, a key federal watchdog said.

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Biden Signs $1.7T Omnibus, Paving Way For Multiple Health Policy Priorities

Just ahead of the year-end deadline, President Joe Biden signed into law a massive $1.7 trillion spending package that includes a slew of healthcare policy priorities. Biden signed the bill late on Dec. 29 after it was flown to him while vacationing during the holidays in the U.S. Virgin Islands, the White House said. In ...

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Congress Reaches Major Health Policy Deal On Medicare, Medicaid, And Pandemic Preparedness

Leaders in Congress have reached a sweeping deal to ease Medicare pay cuts to doctors, make major changes to post-pandemic Medicaid policy, and to help prepare for future pandemics.

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CMS Proposes Cap On Nonstandard ACA Plans, Network Adequacy Standard Changes For 2024

The Biden administration wants to limit to two the number of nonstandardized Affordable Care Act (ACA) exchange plans an insurer can offer on in 2024 as part of an effort to make it easier for consumers to pick a plan. The Centers for Medicare & Medicaid Services (CMS) released Monday the proposed Notice of ...

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CMS Proposes New Medicare Advantage And Part D Reforms On Prior Authorization, Marketing

The Biden administration released a proposal to streamline Medicare Advantage (MA) and Part D plan prior authorization and add health equity requirements to star ratings. The Centers for Medicare & Medicaid Services (CMS) released a proposed rule Wednesday outlining policies for MA and Part D plans for the 2024 coverage year and implementing drug price provisions in ...

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Biden Administration Proposes Crackdown On Scam Medicare Ads

The Biden administration on Wednesday proposed a ban on misleading ads for Medicare Advantage plans that have targeted older Americans and, in some cases, convinced them to sign up for plans that don’t cover their doctors or prescriptions.

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Health Insurance is Helping Cool Inflation. But ‘It’s Not a Very Good Reflection’ of What People Pay, Cautions Economist

In an environment of high inflation, health insurance costs are doing the opposite: They’ve begun to deflate, and are poised to continue dropping each month until fall 2023, economists predict. Health insurance prices fell by 4% in October and 4.3% in November, according to the consumer price index, a key measure of inflation. By comparison, the ...

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MedPAC Wants Pay Boost For Docs And Hospitals

MedPAC wants Congress to increase hospitals and clinicians’ 2o24 Medicare payment rates. Why it matters: If Congress opts not to follow the recommendations, CMS has to make payment updates according to current law — setting up another year of providers running to lawmakers for relief from Medicare cuts after the fact. * Commissioners hashed out draft payment recommendations ...

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