Tag: Medicare

Medicare's 2025 Primary Care Payment Reforms Signal Major Funding Shift

Medicare's 2025 Primary Care Payment Reforms Signal Major Funding Shift

Medicare's 2025 payment updates introduce advanced primary care and behavioral health codes poised to reshape reimbursement landscapes, addressing primary care financial challenges and influencing specialist payment cuts.

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.

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.

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.

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.

Health Insurance Premiums and Out-of-Pocket Costs to Rise Sharply in 2026

Explore the factors driving significant health insurance premium and out-of-pocket cost increases in 2026 across employer-sponsored plans, ACA exchanges, Medicare, and Medicaid. Understand how subsidy expirations and policy changes impact affordability and coverage.

FTC Warns Healthcare Employers on Noncompetes; Industry Sees Rising Unionization and Tech Advances

FTC cautions healthcare employers on noncompetes. Rising physician unionization, Medicare Plan Finder updates, Kaiser-Renown joint venture, AI tools, FDA drug approvals, and robotic intubation device mark key healthcare industry trends in 2025.