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Medicare

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Medicare Watchdog Seats Have Gone Unfilled for Nearly a Decade

Medicare, Social Security public trustees are supposed to safeguard reports' accuracy

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What if Medicaid Enrollees Were Given Cash Instead of Insurance Benefits?

Having them buy insurance or pay for services directly would bring down prices, supporters say

A screenshot of Timothy Richardson, MD, speaking during this hearing.

More Money, Fewer Prior Auths Needed to Save Private Practices, Lawmakers Told

Medicare rates' failure to keep up with inflation is especially damaging, doctors say

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Can Medicare Money Protect Doctors From Abortion Crimes? It Has Worked Before.

Idaho abortion ruling may depend on federal spending power shielding doctors from state charges

A photo of a female physician holding a fan of $100 bills.

Senate Paper Mulls Options for Fixing Physician Pay in Fee-for-Service Medicare

Regular inflation updates, getting rid of MIPS among the ideas discussed

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When It Comes to Preventive Health, Play the Long Game

Proposed budget scoring legislation can boost disease prevention and drive cost savings

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Medicare Hospital Trust Fund to Stay Solvent Until 2036, Trustees' Report Says

Projection is 5 years longer than last year's prediction

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Fed Up With Prior Auths? What if Insurers Had to Pay You for Submitting Them?

NYC urologist is seeking approval for a prior authorization CPT code

A photo of a mature male physician looking out the window of a hospital lobby.

The Plight of the Late-Boomer Physician

Does anyone besides me feel like we got the short end of the financial stick?

Medicare Drug Price Negotiation; Diagnostic Errors

Also in TTHealthWatch: neomycin for preventing respiratory viral infections

A photo of a Humana health insurance building.

Discerning the Truth About the Medicare Advantage Controversy

Evidence shows higher-quality care compared with fee-for-service, but also overpayments

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CMS Pushes Back on Criticism of Nursing Home Staffing Rule

Rule is needed because many nursing home patients don't get needed care, CMS administrator says

A screenshot of HHS Secretary Xavier Becerra speaking during this hearing.

Becerra Gets Sharp Questions From All Sides at Budget Hearing

House members cite lack of action and funding on physician payment reform and other issues

A screenshot of Frank Pallone speaking during this hearing.

Improper Payments in Medicare and Medicaid: Who's at Fault?

Republicans and Democrats took differing approaches on the subject at a House hearing

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The 340B Program Isn't Going Anywhere, Lawmaker Tells Hospital Executives

Rep says it's a great program that helps rural areas, and needs to continue

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MedPAC Wrestles With Wide Variation in Generic Rx Prices, Availability

Commissioners baffled by factors affecting Part D drug prices

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Congress Can Take Action to Prevent Older Adult Falls and Associated Opioid Use

The bipartisan SAFE Act offers important solutions

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CMS Officials Pressed on Catheter Fraud Issue at Accountable Care Meeting

"We just kindly ask that you address the issue with higher urgency," said one ACO member

A screenshot of Amol Navathe, MD, PhD, speaking during this hearing.

More Medicare $$ Needed to Pay Docs for Treating the Chronically Ill, Senators Told

Payment codes are underused because "the cost of billing them is itself unprofitable"

A screenshot of Lee Schwamm, MD, speaking during this hearing.

House Members Struggle to Craft Road Map for Future of Telehealth

Lawmakers examine issues around reimbursement, licensure, and patient choice

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More Health Systems Likely to Drop Out of Medicare Advantage, Analyst Predicts

Claims denials, prior authorizations are just some of the reasons, he says

A close up photo of two Wegovy injection pens.

Medicare Can Cover Anti-Obesity Drugs for Heart Disease -- But at What Cost?

Intense demand coupled with high costs may place pressures on CMS for years to come

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Here's What Medicaid Expansion Can Do for the Health of Your State

Texas -- and 10 other states -- should accept this additional federal funding

A photo of President Joe Biden and Vice President Kamala Harris during the State of the Union speech.

Victory Over Big Pharma Will Take More Than the IRA

We need policies to address high launch prices and anti-competitive patent practices

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Washington and New Jersey Are Reforming Prior Authorization. Is Your State Next?

Broad grassroots support can make a big difference

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Medicare Debuts Another Primary Care-Focused Accountable Care Model

Primary Care Flex will pay ACOs a monthly fee to be given to primary care practices

A photo of a box of Wegovy injection pens.

Medicare to Cover Weight-Loss Drug Wegovy for Certain Patients

News comes in the wake of FDA approval to reduce risk of heart attacks, stroke

A photo of seniors in a nursing home.

The Case for Stricter Standards in the Final Nursing Home Staffing Rule

Continued understaffing will have devastating consequences for residents, families, and staff

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What's Happening With the Medicare Drug-Price Negotiation Lawsuits?

The government has come out on top so far, but pharma vows to fight on, expert says

A screen shot of Robert Morris speaking during this hearing

Medicare $$ Needed to Help State-Licensed Emergency Centers Survive, Lawmakers Told

"This model doesn't work" without it, says emergency center CEO

A photo of a senior patient using a walker in the hallway of a nursing home.

MedPAC's Report Recommends Pay Changes for Healthcare Services

Report highlights MA quality, overpayment issues, and urges action on four prior recommendations

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MedPod Today: AAMC Leaked Emails; 'Wild West' of Ketamine; MA Games the System

番茄社区 reporters offer further insights on these recently covered topics

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Trump Reverses on Medicare Cuts; Pill for Ebola? Chef Jailed for Serving Norovirus

Health news and commentary from around the Web gathered by 番茄社区 staff

A screenshot of Xavier Becerra speaking during this hearing.

Republican Senators Blast Biden's Proposed HHS Budget

At issue were the exclusion of PBM reform, and nursing home, Title X funding requirements

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It's Match Week, but That Won't Fix the Physician Shortage

Short-term legislative solutions can help today in the face of stagnant systemic change

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HHS Aims to Lower Drug Costs, Fund Public Health Preparedness in Budget Proposal

Another goal of FY 2025 budget is to protect reproductive healthcare, behavioral health workforce

A photo of a table set up in front of a van advertising Medicare Advantage plans to passersby.

MedPAC Wrestles With How to Fix Deep Flaws in Medicare Advantage Quality Metrics

Comparing MA plans with fee-for-service quality called "a hornet's nest"

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Largest Independent Primary Care Network in the U.S. Accused of Medicare Fraud

Whistleblower lawsuit alleges Aledade encouraged doctors to tack on suspect medical diagnoses

A photo of ambulances outside of a hospital in Montgomery, Alabama.

MedPAC Members Pan Rural Hospitals' 'Cost-Plus' Billing System for Medicare Patients

Allowing the system to stay in place is "unconscionable," says one commissioner

A photo of Christopher Koller speaking during this hearing

Medicare a Big Contributor to the Broken Health Payment System, Senators Told

Use of "hybrid" payment model urged

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