Centers for Medicare & Medicaid Services

Medicare negotiated drug prices for the first time. Here’s what it got

5:00am August 15, 2024

The White House announced new Medicare drug prices for 10 medicines popular with beneficiaries. It's the first time the federal program has negotiated lower prices with the pharmaceutical industry.

The Biden administration is establishing new standards for how much time each day a nursing home resident gets direct care from a nurse or an aide.

Most nursing homes don't have enough staff to meet the federal government's new rules

7:22pm April 24, 2024

by Jordan Rau

The new rules mean 4 out of 5 nursing homes will need more aides and nurses. Unions hailed the change, but advocates say it's not enough care, while nursing home owners say it's an "impossible task."

Medicare enrollees with two or more chronic conditions are eligible for Chronic Care Management, which pays doctors to check in with those patients monthly. But the service hasn't caught on.

Health & Safety

Medicare's push to improve chronic care attracts businesses, but not many doctors

5:01am April 17, 2024

Most Medicare enrollees have two or more chronic conditions, making them eligible for a program that rewards physicians for doing more to manage their care. But not many doctors have joined.

A woman stands in the middle of a dark maze. Lights guide the way for her. It illustrates the concept of standing in front of a challenge and finding the right solution to move on.

Health & Safety

Mental health care is hard to find, especially for people with Medicare or Medicaid

4:20pm April 03, 2024

by Rhitu Chatterjee

A report from the Department of Health and Human Services' inspector general finds a dire shortage of mental health care providers in Medicaid and Medicare, which together serve some 40% of Americans.

Hospitals in rural America face a dire financial forecast. The government has an incentive plan to help them keep their emergency departments open, while shutting their inpatient services.

Health & Safety

Federal fix for rural hospitals gets few takers so far

5:00am January 10, 2024

Just 18 facilities were converted into Rural Emergency Hospitals so far. Advocates and lawmakers say tweaks to the law are needed to widen the reach and keep health care in rural communities.

People gathered at the U.S. Capitol in Washington, D.C. in July at a rally held by the Center for Medicare Advocacy. They protested denials and delays in private Medicare Advantage plans.

Health & Safety

Uncle Sam wants you to help stop insurers' bogus Medicare Advantage sales tactics

8:59am November 30, 2023

by Susan Jaffe

The Biden administration is cracking down on deceptive or misleading Medicare Advantage and drug plan sales tactics. And it's counting on beneficiaries to help catch offenders.

Rep. Matt Gaetz, R-Fla., and other members of the right-wing House Freedom Caucus could force a federal government shutdown Oct. 1. The National Institutes of Health and the Centers for Disease Control and prevention would be affected.

What happens to health programs if the federal government shuts down?

10:26pm September 27, 2023

by Julie Rovner

Medicare and Medicaid are mandatory spending programs and that keeps them relatively safe in the early days of the shutdown, but 42% of the Department of Health's staff will be furloughed.

SEIU nursing home workers have been calling for safer staffing levels for years.

Health & Safety

Labor unions praise Biden's plan to boost staffing at nursing homes

6:32pm September 01, 2023

For the first time ever, nursing homes may soon have to guarantee a registered nurse is working 24/7 in every facility.

Jen Coghlan outside the home where she grew up in Perry, Iowa. Her father, Henry Ruhl, plans to leave the house to her, but Coghlan expects she'll have to sell it after he dies to settle a $226,611 from Medicaid for the care of her mother, who died in 2022. Coghlan says the family didn't realize that her mother was on Medicaid.

Health & Safety

They could lose the house — to Medicaid

12:02pm March 01, 2023

by Tony Leys

Depending on where they lived, demands for repayment can drain the assets that a patient on Medicaid leaves behind after they die. Iowa aggressively collects "clawback" funds.

Idaho removed nearly 10,000 people from Medicaid in the pandemic's first years when enrollees couldn't be reached. The episode previews what could occur in other states after April 1, when a COVID-era coverage mandate ends.

Health & Safety

Idaho dropped thousands from Medicaid early in the pandemic. Which state's next?

5:01am February 27, 2023

by Rachana Pradhan

The federal agency that oversees Medicaid suggested Idaho wasn't trying hard enough to reach beneficiaries before letting their coverage lapse. Consumer advocates fear that could happen again.