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The anti-fraud efforts highlight a broader political fight ahead of the midterms. Republicans say theyāre protecting taxpayer dollars by going after bad actors. Democrats contend the administration is ā with insufficient evidence ā targeting blue states to cut programs the GOP has long sought to shrink.
The Trump administration has provided few details about its process for canceling hundreds of thousands of Affordable Care Act marketplace enrollments ā even as the next stage of the anti-fraud effort is underway.
A Slack workspace managed by the Centers for Medicare & Medicaid Services has served as an extraordinary war room for AI industry insiders and Trump administration officials to launch a rapid campaign aimed at persuading Americans to manage their healthcare and medical records on apps.
At least 2 million seniors will receive notice this fall that their Medicare Advantage plans will disappear at yearās end, some without a comparable alternative. Hereās a look at this increasingly common problem with Medicare Advantage, and what it says about Medicare as a whole.
As the oldest baby boomers turn 80, researchers worry there wonāt be enough room in nursing facilities for a rapidly graying nation.
The case was brought by a marketing company that wants to define as employees people who download an app and agree to have their internet activity tracked so they can buy into its employee health plan. Such plans are generally exempt from some state and Affordable Care Act rules.
The agreements, covering issues like drug pricing, reducing the use of synthetic food dyes, and cutting back on insurance prior authorization rules, were announced with fanfare and touted as victories. But itās not clear whether theyāll result in lasting change.
States must submit Rural Health Transformation Program progress reports to the federal government, but they arenāt required to proactively post those reports, or related information, publicly.
Conservatives who have long pushed for Medicaid work requirements often said vulnerable people would get a pass. But the federal governmentās list of exemptions left off homeless people.
Rising premiums forced many people in Affordable Care Act plans to give up their coverage. But the Trump administration claims a huge drop in enrollment is almost entirely due to its fraud crackdown.
While acknowledging that changes must be made to the hospice industry, health policy researchers and providers worry that negative attention and the potential for overly punitive regulations could put patients at risk.
Final regulations on Medicaid work requirements say enrollees must regularly obtain documentation ā possibly from medical professionals ā to prove that theyāre too sick to work. Doctors say the rules put them in a tough spot.
Nursing homes and assisted living facilities can be fertile ground for violence between residents with dementia, including fatal assaults. A ³Ō¹Ļ²»“ņģČ examination of health reports and court records shows how warning signs are missed and safeguards fall short.
Last year, the Trump administration announced a voluntary pledge by dozens of insurers to improve prior authorization, which often requires patients to seek approval before treatments. But prior authorization remains commonplace, and there's no evidence the government is trying to hold insurers to account.
With the federal Medicaid work requirements looming in January, Democrats are considering state legislation to call out big companies that employ workers enrolled in the safety net health program. Business giants such as Amazon and Walmart said the figures are misleading.
Republicans say Californiaās use of Medicaid money for social services amounts to waste, fraud, and abuse. But even as Gov. Gavin Newsom voices concern about losing funding, he says heās proud of the stateās holistic approach to caring for its sickest and most expensive patients.
New Medicaid work requirements could make a complex system even harder for farmworkers to navigate.
Thousands of people who had a Medicare drug plan with zero-dollar premiums last year got small premium increases this year ā and didnāt know it. They were dropped from their coverage for failing to pay amounts as little as $8, and most canāt get it again until 2027.
The payment by Elevance Health to the Centers for Medicare & Medicaid Services comes as the agency threatened to bar new enrollments in the companyās plans.
Mehmet Oz, head of the Centers for Medicare & Medicaid Services, framed the $50 billion Rural Health Transformation Program as ābold, creative plansā led by states. But as states have started to roll out their plans, federal officials control where and how the money is spent.
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