Among those who were insured all year in 2023, almost a quarter (23%) were underinsured, meaning they had coverage for a full year that didn’t provide them with affordable access to healthcare, according to a new survey from the Commonwealth Fund.
Category: Medicare and Medicaid, Legislation, Public Policy
Texas pauses Medicaid contracts worth $116 billion
The state of Texas is applying the brakes to its new Medicaid contracts, with a Travis County district judge issuing a temporary injunction that stops the Texas Health and Human Services Commission (HHSC) from carrying out new contracts for the Medicai…
Medicaid insurers ‘missing opportunities’ to improve maternal care
States could do more to require Medicaid managed care organizations (MCOs) to improve access for maternal health, according to an Office of Inspector General report.
OIG: Opioid treatment gaps persist among Medicare, Medicaid enrollees
There are significant barriers to accessing medications for opioid use disorder (OUD) among Medicare and Medicaid beneficiaries, particularly in rural and underserved areas, with many counties lacking either medication for opioid use disorder (MOUD) or…
UnitedHealthcare sues CMS over Medicare Advantage star ratings downgrade
UnitedHealthcare, one of the largest players in the Medicare Advantage market, has filed a lawsuit against the Centers for Medicare and Medicaid Services (CMS) following a downgrade in its star ratings.
OIG: New York paid $23.3 million in Medicaid payments to deceased beneficiaries
An audit finds $7.8M in federal funds were claimed for enrollees who were incorrectly assigned to eligibility groups.
Average premiums for Medicare Advantage, Medicare Part D to decrease, CMS says
The lower MA premiums are expected to drive enrollment to 35.7 million by 2025 – about 51% of all Medicare beneficiaries.
OIG: Remote patient monitoring in Medicare increasing
OIG identified systemic issues that impair Medicaid’s ability to root out fraudulent activities and offered several recommendations.
Medicaid enrollment higher than before the pandemic, KFF finds
More than 25 million people were disenrolled from Medicaid during the unwinding process, and over 56 million had their coverage renewed.
Humana to pay $90 million to settle allegedly fraudulent Part D bids
Insurer Humana has said it will pay $90 million to resolve a False Claims Act case alleging that the company submitted fraudulent bids to the Centers for Medicare and Medicaid Services to secure Part D prescription drug contracts between 2011 and 2017….
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