Medicare Breakthrough Medtech Coverage Advances with Congressional Backing

The U.S. House advances legislation ensuring Medicare coverage for FDA-authorized breakthrough medical technologies, boosting patient access and streamlining approval processes.

Medicare Limits Nursing Home Coverage: What Insurance Pros Need to Know

Medicare covers short-term skilled nursing care but excludes long-term custodial care in nursing homes. Insurance professionals must understand coverage nuances, eligibility, and alternative financing options including Medicaid and long-term care insurance.

AHA Supports Extension of Medicare Waivers for Hospital-at-Home Program

The AHA backs legislation to extend Medicare waivers for hospital-at-home programs, aiming to improve care quality and cost efficiency under new healthcare bills reviewed by Congress.

Rhode Island Faces Major Health Insurance Premium Hikes After Federal Subsidy Expiration

Rhode Island's health insurance marketplace faces sharp premium increases and enrollment declines after expiration of federal Enhanced Premium Tax Credits. State officials urge congressional action to restore subsidies and maintain affordable coverage.

Two South Florida Men Indicted in $34.8M Medicare Durable Medical Equipment Fraud Scheme

Two South Florida men indicted for a $34.8 million Medicare fraud involving medically unnecessary durable medical equipment and illegal kickbacks. Highlights compliance and regulatory risks in Medicare billing.

Johns Hopkins Medicine Ends Contract Talks with UnitedHealthcare Over Treatment Terms

Johns Hopkins Medicine ends contract negotiations with UnitedHealthcare after eight months amid disputes over treatment refusal language in employer-based insurance plans. Highlights payer-provider tensions over network participation and patient access.

Key Developments in U.S. Prior Authorization Reform Legislation and CMS Initiatives

Explore recent legislative and CMS efforts to reform prior authorization in U.S. healthcare, focusing on bipartisan bill progress, CMS regulations, and new experimental models to streamline Medicare prior authorization processes.

Senators Reintroduce Bill to Expand Medicare Coverage for Pharmacist Services in Underserved Areas

Bipartisan bill reintroduced to authorize Medicare payments for pharmacists providing basic medical services in underserved and rural areas, enhancing healthcare access for seniors.

MAHA Commission's Childhood Health Strategy Focuses on Hospital Nutrition & Price Transparency

The MAHA Commission's new strategic report outlines a multi-agency approach to reduce childhood chronic diseases by enhancing hospital nutrition standards, clinical trial engagement, and advancing price transparency regulations.

CMS Launches $50B Rural Health Transformation Program with Nov. 5 Deadline

CMS invites states to apply for the $50B Rural Health Transformation program aimed at improving rural health outcomes, with a Nov. 5 deadline and specific funding rules.