Medicare & Medicaid
The FDA does not know or consider pricing when it grants approval of new drugs, causing problems for insurers and Medicaid about its coverage.
Anthem's Medicare insurance coordination services vendor discovered in April that an employee was stealing and misusing Medicaid member data from as early as July 2016.
Two million Americans rely on home-based care services paid by Medicaid to live at home, which can save Medicaid up to two-thirds of what it would cost at a nursing home.
Despite failed ACA repeal efforts, states can request waivers from the administration but experts say this goes beyond executive branch's authority.
By law, $43 billion in Medicaid DHS funding would be cut through 2025.
Home health agencies could see decreases of $80 million in 2017 and $950 million in 2019.
CMS Innovation Center to hold behavioral health summit in September to get feedback for new models.
Federal reports in recent years from Medicare advisory board, as well as GAO and OIG, have raised concerns about 340B program.
CMS said new physician fee schedule rules would encourage fairer competition between hospitals and physician practices and align payment.
A subset of Medicare Advantage plans are designed for people who require at least 90 days of skilled services from nursing homes or long-term care institutions.