Medicare & Medicaid

Donald Trump is calling for a change in the way Medicare deals with big pharma prices, a revision long targeted by Democrats.

Deficiencies found in an audit of Cigna-HealthSpring operations has prompted the Centers for Medicare and Medicaid Services to temporarily bar Cigna from enrolling new customers to its Medicare Advantage and stand-alone prescription drug plans, and from marketing efforts, according to CMS.

The Centers for Medicare and Medicaid Services on Friday said a demonstration of new incentives to align dual-eligible spending shows a 6 percent savings, or $21.6 million, in Medicare spending.

CenterLight admitted to improperly billing Medicaid for 1,241 members.

Patricia Akamnonu kept a working Medicare group provider number for her agency for the purposes of submitting Medicare claims for home health services that either weren't needed or were never actually performed, authorities said.

One week after Andy Slavitt said meaningful use would be replaced soon, the acting Centers for Medicare and Medicaid Services administrator and national coordinator Karen DeSalvo made it clear that the changes would take time and that providers must still follow the current program.

Sentencing continues for family members involved in a Medicare Part D fraud scheme that bilked the system for more than $20 million and saw its perpetrators using the funds to buy luxury cars and fund other businesses, said the FBI and the U.S. Attorney's Office, Southern District of Florida.

A nonprofit specializing in financial assistance for underinsured Americans has opened a new fund to provide help to Medicare patients suffering from renal cell carcinoma. It is the second fund launched this month by the HealthWell Foundation, an independent organization which provides a financial safety net for more than 200,000 underinsured patients by facilitating access to otherwise unaffordable medical treatments.

The state of Maryland is proposing significant changes to how its Medicaid system doles out cash to methadone treatment clinics. And some operators of such facilities aren't happy about it.

A pre-authorization process for certain medical supplies has worked to bring down costs in sample studies and will help prevent questionable billing practices. That's the word from the Centers for Medicare and Medicaid Services, after issuing its final rule Tuesday establishing a prior authorization process for certain durable medical equipment, prosthetics, orthotics and supplies.