The Biden administration on Monday finalized an oft-delayed plan to step up audits of Medicare Advantage insurers in order to identify and recover overpayments. Why it matters: Studies and audits have identified billions of dollars of excess payments to health plans that weren’t supported by patients’ medical records, but federal officials in the past backed off many ...

From defining “fiduciary” and “employer” to seeking feedback on pooled employer plans, the Department of Labor has released an ambitious regulatory agenda for the next six months. “Our Regulatory Agenda additionally reflects our ongoing commitment to the Biden Administration’s prioritization of economic security, raising wages, supporting worker organizing and empowerment, and addressing the threat of climate change, ...

Sen. Bernie Sanders has long made no secret that he thinks drug companies and health insurers are ripping off Americans. But now he’s chairman of the Senate health committee. Why it matters: Sanders has signaled an early focus of the committee’s work will be drug prices, and manufacturers are bracing for some contentious hearings. * “I ...

As congressional lawmakers in the House slog through the early stages of negotiating over the debt ceiling — the amount of money the U.S. government can borrow — there’s been concern that those discussions could include spending cuts to Medicare. However, House Speaker Kevin McCarthy, R-Calif., has now made assurances that Medicare is off-limits during these negotiations (as is Social ...

Factions of the health care system and members of Congress are turning their fire on an oft-maligned part of the drug pricing system — the middlemen who negotiate discounts with drug companies on behalf of health plans. The business practices of pharmacy benefit managers, or PBMs, have attracted the ire of community pharmacies, health care ...

With 2022 now in the rear-view mirror, let’s take a moment to look at some of key health care and health insurance-related news from last year. Reduced Life Expectancy Data released by the Centers for Disease Control and Prevention (CDC) in December 2022 shows the average life expectancy for Americans declined by more than seven ...