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.

Drug Prices Negotiated by Medicare Still Higher Than Other Countries’

Prices for the first 10 drugs negotiated by Medicare fell from their initial net prices, but all drugs except one remained more expensive in the U.S. than in peer countries, researchers said.

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Biden Proposes Medicare, Medicaid Cover Anti-Obesity Drugs

The Centers for Medicare & Medicaid Services is attempting to cover anti-obesity medications under Medicare Part D and Medicaid, the agency announced Nov. 26. Under the Contract Year 2026 MA and Part D proposed rule (PDF), CMS is choosing to follow conventional medical thinking that obesity is a disease. As such, the agency is then able to ...

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Biden Wants Medicare To Cover Weight-Loss Drugs For Millions. RFK Jr Is Likely To Step In

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.

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The Inflation Reduction Act’s Implications For Employer-Sponsored Health Plans

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.

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California and Other States Rush Medicaid Requests Before Trump Return

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.

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Medicare Spent $2B On Unneeded Back Surgeries

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 ...

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California Expanded Medi-Cal to Unauthorized Residents. The Results Are Mixed.

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.

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The Inflation Reduction Act’s Implications For Employer-Sponsored Health Plans

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.

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Election Outcome Could Bring Big Changes to Medicare

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.

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Physicians, Hospitals Decry 2025 Medicare Payment Rates

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%.

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