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.
The Centers for Medicare & Medicaid Services (CMS) finalized an increase of the average benchmark payments to Medicare Advantage (MA) plans by 5.06%, or $25 billion, on Monday. It is nearly a three-percentage-point increase over the advance notice proposed in the waning days of the Biden administration and will be seen as favorable to payers. ...
The Centers for Medicare & Medicaid Services (CMS) finalized a Medicare Advantage (MA) rule proposed by the Biden administration but is choosing to leave out the rule’s flashiest policy. As outlined by the CMS, the Trump administration’s final rule will not include three proposals included in the initial proposal, including the plan to cover anti-obesity ...
PBMs, which administer prescription drug benefits for health insurance plans, employers, and other organizations including governments, are driving up prescription drug costs, putting small pharmacies out of business, and interfering with doctor and patient relationships, says Sen. Rochelle Nguyen
The Trump administration and Republicans broadly have said they can cut Medicaid’s budget without hurting patient care by finding efficiencies. Colorado Rep. Diana DeGette, the top Democrat on a key health care panel, says that’s not so. “We just simply don’t have that much money,” DeGette said at POLITICO’s Health Care Summit Wednesday. President Donald ...
Bipartisan lawmakers have introduced a bill that aims to more closely align Medicare insurers’ prior authorization denials with medical need, as determined by board-certified specialist physicians.
Nonprofit hospitals’ 2024 financial performances are beating the prior year’s tough numbers, though even the stronger organizations remain “well below pre-pandemic levels,” Fitch Ratings said. In a Thursday brief describing the financial profiles of its rated nonprofit hospitals, the agency attributed the year-to-year improvements to stronger revenues and volumes as well as slightly mitigated, but ...
Nearly 800,000 Nevadans are covered by Medicaid, a federal health insurance program used by one in five Americans who would otherwise struggle to afford medical care.
The Silver State plans to award managed care contracts to incumbents UnitedHealth, Elevance, Centene and Molina — along with CareSource, a newcomer to the state.
Cigna has officially sealed the deal on the $3.3 billion sale of its Medicare business to Health Care Service Corporation. HCSC acquired Cigna’s Medicare Advantage, Part D, supplemental benefits and CareAllies units as part of the deal. While it will no longer operate the Medicare unit directly, Cigna said it will continue to provide pharmacy ...
Telehealth groups celebrated the extension, but added that the short-term reprieve means continued uncertainty for providers.