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News
Medicare Will Stop Requiring Nursing Homes to Report Staff COVID Vaccination Rates
2+ hour ago (1100+ words) Families choosing a nursing home will eventually lose access to two pieces of information that Medicare has collected since the pandemic: how many staff members at a facility are vaccinated against COVID-19, and how many residents are up to date…...
Medicare Is Dropping Two Alcohol and Tobacco Measures from Its Quality Program for Psychiatric Hospitals
1+ hour ago (853+ words) Starting with care delivered in 2026, inpatient psychiatric units will no longer have to tell Medicare whether they offered patients help with drinking or smoking. The population affected is one that carries an unusually heavy substance use burden. Adults hospitalized for…...
How to Read a Medicare Summary Notice and Report Care You Never Received
7+ hour, 35+ min ago (982+ words) The single most useful anti-fraud tool available to a Medicare beneficiary arrives in the mail every three months and is thrown away unopened by a great many of the people it protects. The Medicare Summary Notice is a quarterly statement…...
A Medicare Prior Authorization Pilot Has Run in Six States Since January Without Most Patients Knowing
6+ hour, 15+ min ago (862+ words) If a spine injection or a similar outpatient procedure was delayed this year and nobody explained why, a federal pilot program that began in January may be the reason. The WISeR model, short for Wasteful and Inappropriate Service Reduction, launched…...
Medicare Just Fined 14 Insurers as the Electronic Prior Authorization Deadline Approaches
23+ hour, 45+ min ago (993+ words) Federal regulators fined 14 Medicare insurers a combined $1.54 million and described a pattern of system failures that left patients without medications they were entitled to receive, in an audit report released this week. The Contract Year 2025 Part C and Part D…...
Medicare to End Premium Stabilization Program for Standalone Drug Plans
1+ day, 1+ hour ago (1121+ words) Medicare will end the federal program that has been holding down premiums for standalone prescription drug plans since 2025, the Centers for Medicare and Medicaid Services announced on Tuesday, returning the market to what the agency calls traditional conditions in 2027. The…...
CMS Proposes Medicare Physician Pay Cuts of Up to 1.68% in 2027, Putting Rural and Behavioral Health Practices at Risk
1+ week, 1+ day ago (326+ words) According to the CMS fact sheet and analysis by Healthcare Finance News and Holland and Knight: The rule incorporates statutory payment updates of 0.75% for qualifying APM participants and 0.25% for non-participants, plus an estimated 0.53% positive adjustment from proposed changes to work…...
Deloitte's Medicaid Systems Are Wrongly Denying Disabled Americans Benefits in at Least 25 States, KFF Investigation Finds
1+ week, 1+ day ago (363+ words) Deloitte does not operate only in Michigan. The same company holds contracts to build or run Medicaid eligibility systems in at least 25 states, according to KFF Health News, making it the dominant private vendor in the government business of determining…...
$10 Billion Medicare Billing Scheme Allegedly Inflated Premiums for Millions of Americans
1+ mon, 5+ day ago (695+ words) How to Live Better, Longer The Centers for Medicare and Medicaid Services has since restructured the payment system, with a new rule that took effect January 1, 2026, and is projected to reduce gross spending on skin substitutes by $19.6 billion this year…...
Los Angeles Seniors Hit the $2,000 Medicare Drug Cap for the First Time — Here's What Happens to Their Prescriptions for the Rest of 2026
1+ mon, 3+ week ago (305+ words) How to Live Better, Longer The most important Medicare drug benefit change in 21 years began on January 1, 2026, creating a major financial shift for hundreds of thousands of seniors in Los Angeles County. Under the Inflation Reduction Act, Medicare Part D…...