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.
Millions of obese Americans would be eligible to have popular weight-loss drugs like Wegovy or Ozempic covered by Medicare or Medicaid under a new rule the Biden administration proposed on Tuesday. Setting the stage for a potential showdown between the pharmaceutical industry and RFK Jr.
By being prepared and implementing strategic solutions, employers can mitigate some of the financial pressures that may arise from the IRA, ensuring that their employees and retirees are better protected from the ripple effects of this landmark legislation.
States are racing to have their Medicaid requests approved before the Trump administration takes power. The new administration is expected to have a very different view of Medicaid than the Biden administration, and GOP lawmakers in Congress are eyeing major changes.
Hospitals performed more than 200,000 unnecessary back surgeries on Medicare beneficiaries in the U.S. over three years, according to a new analysis. Why it matters: Roughly $2 billion was spent on the “low value” procedures while patients were put at risk of poor outcomes, researchers from the Lown Institute wrote. What they found: The researchers looked at ...
California this year took the final step in opening Medi-Cal, its Medicaid program, to every eligible resident regardless of immigration status. It’s a significant expansion for an already massive safety net program.
By being prepared and implementing strategic solutions, employers can mitigate some of the financial pressures that may arise from the IRA, ensuring that their employees and retirees are better protected from the ripple effects of this landmark legislation.
The election’s outcome could alter the very nature of the nearly 60-year-old federal program. More than half of Medicare beneficiaries are already enrolled in plans, called Medicare Advantage, run by commercial insurers.
Physicians will see their Medicare reimbursement fall 2.9% next year if Congress doesn’t stop the cuts. Meanwhile, reimbursement for hospital outpatient departments is rising 2.9%.
Will any legislation surrounding prior authorization, price transparency or individual coverage health reimbursement arrangements (ICHRAs), for example, make it in an end-of-year package? Movement on new electronic prior auth standards may be possible, we learned.
CMS payment model changes, rising costs and higher utilization. In addition to these Medicare Advantage (MA) stories, which have dominated 2024, the past few weeks have been a cornucopia of new headlines. Their alternate versions might read: When stock value trumps vision. The ouster of CEO Karen Lynch at CVS Health, the possible break-up of its business ...