CMS Excludes Obesity Drugs from Medicare Coverage Amid Cost Concerns
CMS excludes obesity drugs from 2026 Medicare coverage, citing cost concerns; Eli Lilly criticizes the decision impacting obesity management treatments.
Medicare Inflation Rebates: Extending Protections to Medicare Advantage Enrollees
Analysis of inflation rebate implementation under the Inflation Reduction Act highlights the need to include Medicare Advantage enrollees to maximize drug cost savings and deter pharmaceutical price hikes.
Health Exchange Enrollment Hits Record 24.3 Million for 2025 Amid Policy Shifts
Record health insurance enrollment on the 2025 exchanges driven by ACA subsidies faces uncertainty amid proposed federal cuts. CMS reports enrollment up 13%.
CMS Finalizes 2026 Updates for Medicare Advantage and Part D Programs
CMS issued final rules and updates for Medicare Advantage and Part D programs for 2026, including Inflation Reduction Act implementations and inpatient care protections.
Trump Administration Pushes to Make Medicare Advantage Default for All Enrollees
The Trump administration is advancing plans to make Medicare Advantage the default enrollment for all Medicare recipients, raising concerns about beneficiary choice and increased costs to taxpayers.
Conservative Proposals Could Accelerate Medicare Advantage Enrollment Shift
Explore how conservative proposals to alter Medicare enrollment could boost Medicare Advantage participation, impacting program costs and market dynamics.
Federal Cuts Shrink ACA Caseworker Teams Amid Growing Enrollment and Complexity
Federal workforce reductions have eliminated two ACA caseworker divisions, increasing resolution delays amid record 24 million ACA enrollees and upcoming regulatory changes.
CMS Fines Three PACE Organizations for Service and Documentation Failures
CMS fines three PACE organizations totaling $142,788 for failure to meet essential service and documentation requirements, highlighting compliance challenges in managed care programs.
Federal Workforce Cuts Strain ACA Caseworker Support Amid Upcoming Regulatory Changes
Federal workforce reductions within CMS are cutting ACA caseworker staff, risking delays in resolving coverage issues amid upcoming ACA regulatory changes. The strain impacts consumer support and marketplace stability.
CMS ACA Caseworker Reductions Signal Longer Resolution Times Amid Policy Changes
CMS has cut two ACA caseworker teams amid federal staff reductions, risking longer resolution times for 24 million enrollees and raising concerns about fraud and policy change impacts.