Medicare Advantage Company Pays $342M to Government in Midst of Billing Probe
The payment by Elevance Health to the Centers for Medicare & Medicaid Services comes as the agency threatened to bar new enrollments in the company’s plans.
CMS
1 - 20 of 400 Results
-
-
Backed by Threat of Clawbacks, Feds Wield Tight Grip on $50B Rural Health Fund
Mehmet Oz, head of the Centers for Medicare & Medicaid Services, framed the $50 billion Rural Health Transformation Program as “bold, creative plans” led by states. But as states have started to roll out their plans, federal officials control where and how the money is spent.
By Sarah Jane Tribble and Arielle Zionts -
Long-Awaited Rule Aims To Boost ACA Choices While Embracing Higher Deductibles
The Trump administration finalized a rule that embraces new types of Obamacare coverage, including 30% higher out-of-pocket costs for some plans, and a more novel approach that allows insurers to offer coverage without set networks of doctors and hospitals.
-
Final Rules for Medicaid Work Requirements Are Out. Here’s What You Need To Know.
The Trump administration has laid out what millions of Americans on Medicaid must do to prove they’re working or completing other activities. Health policy researchers and consumer advocates say there are some important takeaways.
-
Trump’s Medicaid Work Rules Force States To Scrap Plans and Rework Systems
Health experts and advocates for low-income people say federal rules implementing President Donald Trump’s new Medicaid work requirements upend months of work by state governments to prepare the computer systems that determine who’s eligible for benefits.
By Rachana Pradhan and Samantha Liss -
Trump Bought Stock in Drugmaker as His Government Boosted Its Obesity Drugs
New ethics disclosures show the president invested in Eli Lilly and a company that manufactures injectable devices as his health agencies implemented policies that benefited them.
By Darius Tahir -
A New Medicare Option for Weight Loss Drugs: What Older Americans Should Know
It may soon get easier for millions of people with Medicare to get discounted GLP-1 drugs for weight loss.
-
HHS’ Healthy Food Agenda Puts Hospitals on Notice About Patients’ Meals
The backlash was immediate after the Trump administration served notice that hospitals and nursing homes should limit sugary drinks and dietary supplements in favor of what the Department of Health and Human Services terms “real food.”
-
Big Companies Position Themselves for Payday From $50B Federal Rural Health Fund
A $50 billion federal fund is supposed to modernize rural health with electronic health records, AI, telehealth, and more. But community clinics and rural health advocates fear that the contractors administering the money for states will bite off a big chunk before it reaches rural patients.
-
Florida Delays Children’s Health Insurance Expansion as Uninsured Rate Rises
Florida’s KidCare expansion has been stuck in legal limbo since February 2024. Since then, the number of uninsured children in Florida has risen to 400,000 — one of the highest state tallies.
By Daniel Chang -
A ‘Barbaric’ Problem in American Hospitals Is Only Getting Bigger
Patients are getting stuck in the emergency department for days while waiting for a spot in an inpatient ward.
-
Real Estate Investors Profit From Long-Term Care While Residents Languish
Real estate investment trusts are landlords for thousands of nursing homes, assisted living facilities, and hospitals. Some select the managers and keep close watch over their performance but deny responsibility for bad care.
By Jordan Rau -
New Federal Medicaid Rules Require One Month of Work. Some States Demand More.
Starting next year, about 18.5 million adults will be subject to new Medicaid work rules in 42 states and Washington, D.C. Applicants must show they’ve been working for at least a month before receiving benefits. Some Republican-controlled states want to triple the required work period.
-
States Face Another Challenge With Medicaid Work Rules: Staffing Shortages
Some states already don’t have enough staff to quickly process Medicaid applications and answer enrollees’ phone calls. Researchers say they may not be prepared to handle new Medicaid work rules, predicting people will lose coverage as a result.
-
Trump’s Hunt for Undocumented Medicaid Enrollees Yields Few Violators
Federal health officials have ordered states to reverify the immigration status of hundreds of thousands of Medicaid enrollees. After seven months, findings from five states show the reviews have uncovered few immigrants without legal status who are improperly receiving benefits.
A Headless CDC
Episode 439The Trump administration faces the challenge of naming a new director of the Centers for Disease Control and Prevention who can both satisfy the Make America Healthy Again movement and get confirmed by the Senate. Meanwhile, a new Senate bill to rescind the approval of the abortion pill mifepristone is again elevating the abortion debate, which some Republicans would prefer to stay on the back burner until after the midterms. Shefali Luthra of The 19th, Lizzy Lawrence of Stat, and Rachel Cohrs Zhang of Bloomberg News join KFF Health News’ Julie Rovner to discuss the news. Also this week, Rovner interviews Georgetown University Law Center’s Katie Keith about the state of the Affordable Care Act on its 16th anniversary.
-
Oz Escalates Medicaid Fraud Claims Against States After Focus on Minnesota
The Trump administration’s unprecedented actions targeting Medicaid funding in Minnesota are part of what could become a playbook as officials turn pressure toward California, Florida, Maine, and New York.
-
Oz Says California’s Not Fighting Health Care Fraud, but Data Shows It’s Part of a Larger Battle
Trump administration officials say the state allows rampant fraud and have promised to investigate, blaming the “Russian, Armenian mafia” in the hospice and home health care industry. But data shows hotbeds of health care fraud throughout the country, with California outperforming most other states in recovering fraud dollars.
By Don Thompson -
Medicare Advantage ‘Dark Money’ Group Attempts To Win Higher Payments for Insurance Companies
Medicare Advantage insurers say a proposal by the Trump administration to keep their payments nearly flat next year may lead to service cuts that harm seniors struggling to afford health care. A decision is due by early next month.
RFK Jr.’s Very Bad Week
Episode 437HHS Secretary Robert F. Kennedy Jr. had another tough week. In addition to Kennedy having rotator cuff surgery, the nomination of his ally to become surgeon general is teetering, the controversial head of the FDA's vaccine center is resigning next month, and a new survey shows Americans trust government health officials less than they do former Biden official Anthony Fauci. Anna Edney of Bloomberg News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, and Shefali Luthra of The 19th join KFF Health News’ Julie Rovner to discuss these stories and more.