CMS Increases Oversight to Prevent Improper Medicaid Spending on Noncitizens
CMS ramps up oversight to stop misuse of Medicaid funds for noncitizen coverage, enforcing federal eligibility rules and recouping improper spending.
Federal Agencies Advance Healthcare Price Transparency with New RFIs and Guidance
U.S. federal agencies issue new guidance and requests for information to improve transparency in prescription drug and hospital prices, aiming to enhance data accuracy and compliance.
CMS Amplifies Medicare Advantage RADV Audits and Targets Medicaid Provider Taxes
CMS plans major expansion of Medicare Advantage RADV audits and proposes rules to limit Medicaid provider taxation practices, impacting insurer compliance and Medicaid financing.
CMS Expands Medicare Advantage Audits Impacting Major Health Insurers
CMS expands Medicare Advantage audits from 2018-2024, intensifying compliance demands and financial scrutiny for major health insurers like UnitedHealth, CVS, and Humana.
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.