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Medicare

Medicare Advantage Plans' Prior Auth Rules Would Be Made Public Under CMS Proposal

Rule would also make provider directories easier to compare

Semaglutide (GLP-1) weight-loss drug Wegovy

Biden Proposes Coverage of Obesity Drugs in Medicare, Medicaid

Federal government would pick up about three-fourths of the cost for Medicaid coverage

Morning Break over illustration of a syringe, Covid virus, and DNA helix over a photo of green vegetation.

Dr. Oz's Dubious Claims; Bird Flu Found in Raw Milk; Whooping Cough Surges

Health news and commentary gathered by MedPage Today staff

A photo of Donald Trump.

Trump Is Back: What This Could Mean for Health Policy

Exploring the powers and limits of the Presidency

A photo of Dr. Mehmet Oz speaking at a Trump rally.

Policy Experts Split on Dr. Oz Nomination to Lead CMS

Is he a "threat to public health" or a reasonable choice for the job?

A photo of Mehmet Oz, MD

Trump Taps Dr. Oz to Run CMS

Mehmet Oz, MD, has been an outspoken supporter of the President-elect

A photo of surgeons performing lumbar spine surgery.

Surgeons Billed $2 Billion for Unnecessary Spine Surgeries: Report

Lown Institute names hospitals, states with high rates of overuse

A photo of a stethoscope lying next a tablet where a male physician has a medical coding spreadsheet open.

The Trouble With Upcoding Extends Far Beyond Ethics

The practice reminds us that our healthcare system is failing patients and clinicians alike

AMA over a photo of Walt Disney World Swan and Dolphin Resort in Orlando, FL.

AMA Delegates Dive Into Water Bead Injuries; Patients' 'Scanxiety' Over Test Results

Members also debate alternative ways states can safely license foreign med-school graduates

AMA over a photo of Walt Disney World Swan and Dolphin Resort in Orlando, FL.

Paying Docs for Prior Authorizations Among the Hot Topics at the AMA Meeting

Delegates also mulled resolutions on pediatric hospital closures, public health misinformation

AMA over a photo of Walt Disney World Swan and Dolphin Resort in Orlando, FL.

Fixing Medicare Cuts, Reforming Prior Auth Among AMA's Top Priorities, Says AMA Prez

Bruce Scott, MD, also touches on scope-of-practice issues in speech to House of Delegates

AMA over a photo of Walt Disney World Swan and Dolphin Resort in Orlando, FL.

Does the AMA Need to Right-Size Its House of Delegates?

Departing CEO James Madara, MD, suggests the group's governing body might be getting too large

MedPAC Tackles Accuracy of Medicare Advantage Network Directories

Providers can change any time, leaving patients anxious and stranded, commissioners say

A photo of a female physician taking notes while sitting on a couch next to a man.

Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits

CMS, which runs the Medicare program, disagrees

A photo of Donald Trump exiting Marine One at the White House.

What Happens to Medicare Price Negotiations Under Trump?

Is price negotiation in the next administration's crosshairs or is it "political suicide"?

A photo of The White House in Washington DC.

Trump's White House Return Poised to Tangle Healthcare Safety Net

Public health insurance programs likely to be scaled back

A photo of Donald Trump.

What Trump Has Proposed for Healthcare in a Second Administration

A look at Trump's history and ideas floated on the campaign trail

A photo of a male physician at his desk using a calculator.

Doc Groups Blast 2.8% Cut in Medicare Physician Fee Schedule Final Rule

But extension of telehealth flexibilities and a change to primary care payment draw praise

How the Election Results Could Affect Healthcare in the U.S.

Anand Parekh breaks down the possible futures for abortion rights, EMTALA, and Obamacare

Morning Break over illustration of a syringe, Covid virus, and DNA helix over a photo of green vegetation.

Medicare Finalizes Doc Pay Cut; Mask Mandates Return; Top Voter Concerns

Health news and commentary gathered by MedPage Today staff

A photo of Donald Trump in the Oval Office.

What Will CDC, FDA, and CMS Look Like After the Election?

We talked to healthcare experts to get their predictions for a Trump or Harris administration

A photo of the Capitol building in Washington, D.C. at sunrise.

Backers of Prior Authorization Bill Hopeful for Passage by End of the Year

The bill's cost estimate has dropped from $16 billion to $0, greatly hiking chances of passage

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IG Live November 1: Healthcare Is on the Ballot

Public health and access to care are at stake in the 2024 election

A close up photo of a rolled up $100 bill in the breast pocket of a physician’s white coat.

House Members Introduce Bill to Reverse Pending Medicare Physician Fee Schedule Cut

Measure includes a 1.8% pay increase for clinicians

A photo of the Supreme Court building in Washington, DC.

A Look at the Supreme Court's Upcoming Term

Public health is on the chopping block once again

A photo of a cannula lying on a portable oxygen tank.

Study: Medicare's Competitive Bidding Program Not a Danger to COPD Oxygen Users

Prices went down but reductions in new oxygen prescriptions and discontinuations were minimal

A photo of a female physician using sign language to communicate with her female patient who is also wearing a hearing aid.

Going Beyond Hearing Aids for Equal Care Access

Hearing loss is only becoming more prevalent

AAO over a photo of McCormick Place in Chicago, IL.

Approval of Bevacizumab Biosimilar for Ophthalmic Use Could Upend Low-Cost Anti-VEGF

Provision in drug act would prohibit repackaging Avastin, add millions to anti-VEGF therapy cost

A photo of President Joe Biden and VP Kamala Harris at event announcing lower costs for Medicare prescription drugs

Medicare Drug Plans Are Getting Better Next Year. Some Will Also Cost More.

A redesigned drug benefit will operate more like other private insurance policies

A photo of the Uber and Lyft logos on the windshield of a car for hire.

Patients Are Relying on Lyft, Uber to Travel Far Distances to Medical Care

Some are calling for states to subsidize the expensive trips for rural residents

A close up photo of a robot hand manipulating a computer keyboard.

Doctors, Not AI, Should Authorize Treatments

A new California law shows the way

A photo of the Capitol building in Washington, DC.

Use of Prior Authorization Up in Medicare Advantage Plans, Senate Report Finds

Post-acute care services targeted for coverage denials

A photo of a woman taking a photo of a check with her smartphone to make a deposit.

Want Electronic Reimbursement? That Will Cost You a 5% Fee.

Predatory insurance fees underscore need for physician payment reform

A photo of the US Capitol building in Washington, DC.

Stop the Medicare Payment Cut and Pass a Permanent Fix, House Members Urge Leaders

The Medicare fee schedule is "inherently broken," says bipartisan letter from 233 members

An image of a bottle of LEQUEMBI Injection single-dose vial

Alzheimer's Drug in Smaller Vial Sizes Could Save Medicare Hundreds of Millions

Nearly 6% of lecanemab may be discarded each year

A photo of unoccupied beds in a hospital recovery room.

Hospitals Unhappy With New Requirement to Report Bed Capacity and COVID Count

One group calls it "needlessly heavy-handed"

A photo of a man at the end of a row of people using computers and wearing headsets.

Payments to Medicare Plan Brokers Need Reform, MedPAC Says

No preferential treatment should be given for enrolling people in Medicare Advantage, they argue

A photo of a Medicare advertisement on a digital billboard.

MedPAC Commissioners Pan Some Medicare Advantage Plans' 'Extra Benefits'

Services cost Medicare an extra $83B in 2024; are debit cards and groceries really healthcare?

A photo of a calculator displaying MEDICARE PART D lying on a pile of US currency next to a spilled bottle of pill

CMS Unveils Sample $2 Generic Drug List for Medicare Part D Enrollees

But experts are skeptical the list would have much impact

A computer rendering of nerve cells affected by Alzheimer’s disease.

One Way to Spot Early Cognitive Decline? Medicare Wellness Visits

Annual evaluation tied to timelier mild cognitive impairment diagnoses

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