News
The Shifting Budgetary Outlook for Medicare Part D
1+ day, 3+ hour ago (126+ words) Medicare part D, which covers outpatient prescription drugs, is undergoing a planned transformation from multiple policy interventions, most of which were advertised as relieving financial pressure by lowering the prices charged by the manufacturers. What was not signaled as a…...
CMS Eyes Stricter Medicare Enrollment Rules
3+ day, 2+ hour ago (33+ words) Real Clear Health CMS Eyes Stricter Medicare Enrollment Rules The Centers for Medicare and Medicaid Services released on Wednesday afternoon its 2027 proposed payment rule for home health agencies....
Hospitals Are Gaming Medicare to Consolidate and Raise Costs
1+ week, 5+ day ago (485+ words) Hospital CEOs have been called on the carpet by Congress. Earlier this summer, the House Ways & Means Committee grilled executives from the nation's largest healthcare systems about how they drive up healthcare costs by abusing federal exemptions and program favoritism…...
The Medicare Turf War That's Breaking Hearts
1+ mon, 2+ day ago (17+ words) Real Clear Health The Medicare Turf War That's Breaking Hearts...
Long-Term Care's Enduring Impact on American Health Care
1+ mon, 3+ week ago (302+ words) This week is National Skilled Nursing Care Week " a celebratory recognition of the individuals who reside, work and volunteer in our nation's skilled nursing facilities. Honoring this decades-long tradition is the perfect time to think about long term care holistically…...
Preserve Medicare Advantage
3+ mon, 2+ week ago (994+ words) John is 70 years old, managing diabetes and high blood pressure with doctors he has trusted for years, but that stability disappeared overnight when his health system dropped its Medicare Advantage (MA) contracts, abruptly pushing his care out of network. Now,…...
$193. 6 T in Unfunded Medicare, Social Security Promises
3+ mon, 2+ week ago (14+ words) Real Clear Health $193. 6 T in Unfunded Medicare, Social Security Promises...
Prior Authorization: AHIP's Commitments
5+ mon, 2+ week ago (378+ words) What Is Prior Authorization? Most private payers have prior authorization requirements, including commercial and employer-sponsored plans. Although traditional Medicare only has prior authorization requirements in extremely limited cases, Medicare Advantage plans often do. States and Medicaid managed care organizations are…...
Fix Medicare Physician Payment
5+ mon, 2+ week ago (1609+ words) This year America's doctors can forget raising a glass of celebratory champagne. Despite the congressional enactment of a 2. 5% across the board Medicare payment increase, courtesy of'President Trump's "One Big Beautiful Bill'their pay increase is being'undercut. The Center for Medicare and…...
Examining AHIP's Pledges on Prior Authorization
6+ mon, 1+ week ago (313+ words) These efforts are also important to show that common sense policy changes can be implemented, and implemented quickly, without the need for legislative or regulatory action. By coming to the table to proactively address potential inefficiencies and cost drivers, payers…...