Category: Medicare and Medicaid, Legislation, Public Policy

CMS denies Humana’s Medicare Advantage star ratings appeal

The Centers for Medicare and Medicaid Services has rejected an appeal from Humana to improve the latter’s Medicare Advantage star ratings, which could cost the insurer significant revenue in 2026.
On April 15, Humana and American for Beneficiary Choice…

CMS signals cutting future Medicaid demonstration programs

The Centers for Medicare and Medicaid Services has signaled plans to make cuts to the Medicaid program, saying it wants to put an end to “mounting expenditures,” such as housekeeping for non-Medicaid-eligible individuals, and high-speed internet for ru…

RFK Jr. will reportedly not appear before Senate subcommittee

The chairman and the ranking member of a Senate subcommittee have asked Health and Human Services Secretary Robert F. Kennedy Jr. to participate in a hearing on the reorganization of HHS, but Kennedy, reportedly, will not appear.

Senate Finance Committee advances Dr. Oz’s nomination as CMS administrator

The Senate Finance Committee on Tuesday advanced Dr. Mehmet Oz’s nomination to become administrator of the Centers for Medicare and Medicaid Services.
The 14 to 13 vote was along party lines. Oz next faces a vote for confirmation before the full Senate

CMS cutting four Medicare payment models

The Center for Medicare and Medicaid Innovation (CMMI) is planning on ending four payment models by the end of the year in a bid to achieve a projected $750 million in savings, though the agency did not say where the savings would take place.

CMS cutting four Medicare payment models

The Center for Medicare and Medicaid Innovation (CMMI) is planning on ending four payment models by the end of the year in a bid to achieve a projected $750 million in savings, though the agency did not say where the savings would take place.

Curbing Medicaid expansion could cause $80 billion hit to providers

Cutting Medicaid funding and halting the program’s expansion would result in providers revenues decreasing by about $80 billion, and uncompensated care on behalf of uninsured people would increase by $18.9 billion in 2026 due to declines in health insu…

Most Medicaid adults are working, KFF analysis finds

Four years ago, the Biden administration rolled back a controversial rule that required Medicaid beneficiaries to work in order to receive coverage.

Medicare Advantage insurers made about 50 million prior authorization determinations in 2023

Medicare Advantage insurers made nearly 50 million prior authorization determinations in 2023, reflecting steady increases over the past few years as the number of MA enrollees has grown, according to a new KFF analysis.

CMS withdraws appeal of UnitedHealth’s star ratings lawsuit

The Centers for Medicare and Medicaid Services has withdrawn its appeal of a district court ruling that determined the agency must recalculate Medicare Advantage Star Ratings for UnitedHealthcare.
CMS had originally signaled its intent to file an appea…