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.

Payers, Medicaid Officials Ask Congress For 120-Day Glide Path To End Of COVID-19 Emergency

Several major payer groups and Medicaid advocates are pressing Congress for a 120-day heads up when the COVID-19 public health emergency ends, arguing they need as much time as possible to make Medicaid enrollees aware they could lose coverage. A collection of payer and Medicaid state advocacy groups wrote to congressional leadership on Thursday asking ...

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CMS Delays The Release Of Hospital Star Ratings Due To A Calculation Error

The Centers for Medicare and Medicaid Services is delaying the release of the hospital star ratings from April until June due to an error in one of the measures. CMS is updating the Overall Hospital Quality Star Ratings on the Care Compare website from April until July so it can correct a calculation error in ...

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Trump-Era Medicare Program Under Increased Scrutiny

The Biden administration is debating whether to overhaul a major Trump-era program tied to Medicare as soon as this week in the face of rising pressure from prominent progressive Democrats, more than a half-dozen people familiar with the matter told POLITICO. The Trump program — known as a direct contracting model — allows private companies ...

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Why Millions on Medicaid Are at Risk of Losing Coverage in the Months Ahead

The Biden administration and state officials are bracing for a great unwinding: millions of people losing their Medicaid benefits when the pandemic health emergency ends. Some might sign up for different insurance. Many others are bound to get lost in the transition. State Medicaid agencies for months have been preparing for the end of a ...

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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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