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.

California Opens Medicaid to Older Unauthorized Immigrants

Unauthorized immigrants over age 49 who fall below certain income thresholds are now eligible for full coverage by Medi-Cal, California’s version of Medicaid, the federal-state partnership that provides health insurance to low-income people.

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A Reduction In Medicare Part B Premiums Remains In Play. Here’s Where Things Stand

For Medicare beneficiaries wondering whether their Part B premiums could be reduced, the waiting continues. More than three months after Health and Human Services Secretary Xavier Becerra ordered a reassessment of this year’s $170.10 standard monthly premium — a bigger-than-expected jump from $148.50 in 2021 — it remains uncertain when a determination will come and ...

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CMS Proposes 5 Medicare Special Enrollment Periods

Medicare beneficiaries experiencing specific illnesses or circumstances could soon get Part B coverage outside the normal open enrollment periods under a proposed rule released Friday. Individuals who are impacted by an emergency or disaster, formerly incarcerated people and those subject to a health plan or employer error that prevented them from enrolling in Medicare on ...

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Despite Losing Federal Money, State Is Still Testing Uninsured Residents for COVID — For Now

California is still offering free covid testing to uninsured residents even though the federal government ran out of money to pay for it. While Congress debates whether to put more money into free testing, California is leaning on programs it already had in place: special state-based coverage for uninsured Californians, school testing, and free tests ...

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Trump Era Rule That Expanded Duration Of Short-Term Health Plans In Democrats’ Crosshairs

Democratic lawmakers and advocacy groups are making a push to convince the Biden administration to nix a controversial Trump-era rule that expanded the duration of short-term health plans. A collection of more than 40 House Democrats wrote to Department Health and Human Services (HHS) Secretary Xavier Becerra earlier this week calling for the agency to ...

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FEDERAL “NO SURPRISES ACT” HEALTH PLAN CHANGES – 2022 UPDATE

The federal Consolidated Appropriations Act (CAA) of 2021 brings significant changes to the American health care and health insurance industries – as well as many other changes to unrelated sectors.

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California Is Investigating The Corporation That Took Over Its Medicaid Drug Program

Prescription drug costs for California’s massive Medicaid program were draining the state budget, so in 2019 Gov. Gavin Newsom asked the private sector for help.

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Record Fines Might Mean California Is Finally Serious About Improving Medi-Cal

A few weeks ago, state regulators imposed a record $55 million in fines on L.A. Care, California’s largest Medi-Cal managed-care plan, for failing to ensure adequate care and allowing treatment delays that threatened enrollees’ health. Patient advocates hope the move signals stricter enforcement against other Medi-Cal insurers, which have many of the same shortcomings for which the regulators just fined L.A. Care.

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Push For Single Payer Temporarily Over – But Likely To Return

As you may have read in Paul Roberts’s recent compliance column, A Deep Dive into California “Single Payer,” the most recent effort to pass some sort of single-payer health care legislation in California failed. It marks the sixth time efforts have fallen short in a push to overhaul the state’s health care system.

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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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