Tag: Medicare

Georgia Man Sentenced for Illegal Medicare Genetic Testing Kickback Scheme

Georgia man sentenced to 46 months and $7.2M restitution for illegal Medicare kickbacks tied to unnecessary genetic tests, reflecting enforcement on healthcare fraud.

Pandemic Health Care Subsidies Expiration Threatens ACA Premium Increases

Pandemic health care subsidies ending soon may double ACA premiums without Congressional renewal. Medicare open enrollment deadline approaches amid health policy updates.

Medicare Open Enrollment Deadline Approaches for Nearly 70 Million Beneficiaries

Nearly 70 million Medicare beneficiaries face an upcoming open enrollment deadline, with potential for significant healthcare cost savings by timely plan selection. Resources like Medicare.gov provide essential information.

CMS Proposes Medicare Coverage for CBD Products Under New Regulatory Framework

CMS updates Medicare Advantage policy to allow insurance coverage for federally and state-legal CBD products, amid evolving hemp regulatory definitions and market challenges.

Medicare Fraud Sentencing: $7.2M Restitution and Prison for Peachtree City Man

Patrick Moore Jr. sentenced to 46 months and $7.2M restitution for Medicare fraud involving unnecessary genetic testing and illegal kickbacks.

Medicare Advantage Plan Terminations in Rochester-Finger Lakes Region for 2026

Medicare Advantage plans in Rochester-Finger Lakes are terminating in 2026, requiring beneficiaries to select new plans by Dec 7 or revert to Original Medicare with higher costs. Understand the implications for prescription costs and coverage changes.

CMS WISeR Model Launches AI-Driven Prior Authorization in Medicare

CMS's WISeR Model introduces AI-powered prior authorization for Medicare outpatient procedures, impacting approval times and denials in six states starting 2026.

CMS Proposed 2027 Medicare Advantage and Part D Changes Focus on Simplification and Oversight

CMS releases Proposed 2027 Rules for Medicare Advantage and Part D, emphasizing Star Ratings simplification, marketing oversight updates, expanded risk adjustment data use, and Part D redesign implementation.

Medicare Open Enrollment Deadline Approaches for 70M Beneficiaries

Nearly 70 million Medicare beneficiaries face the approaching open enrollment deadline. Learn how to navigate Medicare.gov for enrollment and potential cost savings.

Medicare Part D Coverage Shrinks in 2026 Amid Plan Reductions and Cost Shifts

Medicare Part D faces significant plan reductions and rising costs in 2026. Beneficiaries must review their drug plans before the December 7 deadline to avoid premium hikes and coverage losses.