SCAN Health Plan Addresses Medicare Patient Challenges with Strategic Initiatives
SCAN Health Plan strategic response to Medicare patient challenges highlights healthcare system inefficiencies and innovation in Medicare managed care.
Medicare Premiums and Plan Changes Signal Market Shifts for 2026
Medicare 2026 premiums surge nearly 10%, with fewer Medicare Advantage plans as insurers scale back. Explore key Medicare cost drivers and market impacts.
Health First Urgent Care Settles $2.8M Medicare Medicaid Overbilling Case
Health First Urgent Care agrees to $2.8 million settlement for Medicare and Medicaid overbilling linked to improper diagnostic test billing practices in Washington State.
CMS Launches Voluntary Medicaid MFN Drug Pricing Model; Trump-Era Manufacturer Agreements Expand
CMS unveils the GENERous Medicaid payment model introducing MFN drug pricing, alongside expanded Trump administration drug pricing agreements and key regulatory updates for 2026.
CMS-Funded GUIDE Program Launches to Enhance Dementia Care Coordination
The CMS-funded GUIDE Program enhances dementia care with coordinated, personalized support for Medicare beneficiaries and caregivers in community settings.
New U.S. Appropriations Act Extends Medicare Telehealth Flexibilities Through Jan 2026
The U.S. government passed H.R. 5371, ending the shutdown and extending Medicare telehealth flexibilities through January 2026, ensuring continued coverage and retroactive payments for telehealth claims.
CMS Launches Ambulatory Specialty Model for Chronic Condition Specialists in 2027
CMS introduces the Ambulatory Specialty Model, a new mandatory payment model for specialists treating low back pain and heart failure, effective from 2027 to improve care quality and reduce costs.
Novo Nordisk, Eli Lilly Cut GLP-1 Prices for Expanded Medicare Market Access
Novo Nordisk and Eli Lilly agree to lower GLP-1 drug prices in exchange for expanded Medicare and Medicaid coverage, marking a major shift in U.S. drug pricing and access.
Medicare Home Health Reimbursement Cut Looms Amid Shutdown Delay
The 2026 Medicare home health final rule release is delayed due to the government shutdown. Proposed 9% reimbursement cuts spark industry-wide concern and strategic responses from key providers and advocacy groups.
Stellar Health's MSSP ACO Achieves $5M Medicare Savings with Tech-Enabled Model
Stellar Health's MSSP ACO surpasses Medicare average savings with $5M saved in 2024, leveraging tech-enabled micro-incentives to improve provider performance and patient outcomes in value-based care.