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Physician groups are seeking a delay for a new Medicare demonstration model. The model debuts January 1 and requires doctors treating low back pain and congestive heart failure to meet performance standards or face payment penalties. That means those physicians could see payment consequences tied to the standards if the model starts on schedule.
Federal Medicare regulators have finalized rules codifying the drug price negotiation framework created by the Inflation Reduction Act. The action locks in that framework while drugmakers continue to press repeated legal challenges in court.
CVS Heath's Aetna is joining the ranks of insurers suing over its results in the 2027 Medicare Advantage star ratings.
HealthTap launched a virtual primary care program for Medicare Advantage plans. The program aims to help members build an ongoing connection with a primary care doctor that carries forward.
HealthQ observed a 22-year-old consult an independent assister about buying health insurance. The assister’s help is free of charge. People who find buying health insurance overwhelming can use such free help to figure it out.
Nebraska spent $8.2 million on contractors to carry out Medicaid work requirements under the One Big Beautiful Bill Act, and a cancer patient was told he had lost coverage. Clinics and advocacy groups for poor and working-class Nebraskans describe the rollout as troubled.
Voter frustration over healthcare costs helped drive Democrats’ midterm takeover of Congress. Democratic control of Congress does not ensure Medicare for All will follow, despite hopes that it would.
When verification fails and an eligible member loses coverage, treatment can be interrupted, medications can go unfilled and manageable conditions can become medical emergencies. The post When Medicaid’s Data Can’t Verify Eligibility, Members Shouldn’t Lose Coverage appeared firs
CVS Health plans to split into two companies by 2028. Experts say the separation may not resolve conflicts of interest between its insurance and pharmacy benefit manager businesses.
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