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.

House Republicans Press HHS To End COVID-19 Emergency, But Hospitals Want Extension

House Republicans are demanding the Biden administration starts winding down the COVID-19 public health emergency, while hospital lobbying groups are pressing it to do the opposite.

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‘Somebody Is Gonna Die’: Medi-Cal Patients Struggle to Fill Prescriptions

A month into its debut, California’s new Medicaid prescription drug program is riddled with problems, leaving thousands of patients without medications — often after languishing on hold for up to eight hours on call center phone lines. On Jan. 1, the state handed control of its Medicaid drug program, known as Medi-Cal Rx, to Magellan Health, ...

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Hospital Price Disclosures Reveal Prices Can Vary By Ten Times

Last month, the federal government revealed that the U.S. spent $4.1 trillion on healthcare in 2020, over 20% of GDP and twice as much as the developed-world average. While hundreds of billions of dollars were spent fighting Covid-19, the overwhelming majority went to propping up the country’s broken healthcare system. National healthcare spending has doubled, adjusted for inflation, since 2000.

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A Deep Dive Into California “Single Payer”

In 2021, the California Assembly introduced a new bill, AB 1400, which – if passed – would have eliminated health care in California, as we know it today. Instead, all health care in California would be provided by one new “Single Payer” system called “CalCare” – with no other options for Californians. The move would have eliminated all existing ...

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Medicare Beneficiaries To Get No-Cost At-Home Covid-19 Tests

People with Medicare will be able to obtain up to eight over-the-counter Covid-19 tests a month for free starting in early spring, the Biden administration said Thursday. Under the plan, Medicare will directly pay certain pharmacies and other participating entities, allowing people with Medicare or Medicare Advantage to pick up the tests for free. “There ...

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Medicare Advantage Plans Could See Nearly 8% Increase In Revenue

The Centers for Medicare and Medicaid Services on Wednesday proposed increasing Medicare Advantage payment by 7.98% in 2023 as they eye future changes to its risk adjustment model. In a proposed payment policy for 2023, the agency asked for feedback on whether MA’s risk adjustment model and star ratings could address the impacts of social ...

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Commercial Insurer Spending Rising Faster Than Medicare

Just over half of the total U.S. population receives health insurance through commercial plans that are offered by employers or purchased by individuals. In recent years, commercial health insurers’ per-person spending on hospitals’ and physicians’ services has grown more quickly than analogous spending by the Medicare fee-for-service (FFS) program, according to analysis by the Congressional ...

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AHIP Warns Proposed ACA Exchange Rule Could Threaten Market’s Growing Stability

AHIP, the top lobbying organization for commercial insurers, is warning the feds that provisions in its proposed rule governing the Affordable Care Act’s exchanges for 2023 could “undermine” the growing stability there. For instance, the group says in comments (PDF) submitted late Thursday that potential changes to requirements for essential health benefits would limit the ability for ...

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Biden Pressured To Cover COVID-19 Tests Through Medicare

The Biden administration is exploring ways for Medicare beneficiaries to get over-the-counter, at-home COVID-19 tests for free. The White House is requiring private insurance companies to cover the cost of eight at-home COVID-19 tests per person each month, if the customer files for reimbursement. The requirement was put in place as a result of the ...

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No Debate On Skyrocketing Cost Of California Single-Payer Bill? So Much For Good Government

This measure, after all, would completely change healthcare coverage for Californians. Insurance companies would be shoved aside. People would be switched from their current coverage — whether private, federal Medicare or Medi-Cal for the poor — to a new state-run plan called CalCare.

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