Medicare & Medicaid

The federal government needs to increase its oversight over private Medicare health plans to make sure seniors have adequate access to doctors and hospitals, according to a report released this week by congressional auditors.

Eight of 10 people surveyed by the Kaiser Family Foundation supported the government or insurers paying for planning discussions about the type of care patients preferred in the waning days or weeks of their lives.

The Part D Enhanced Medication Therapy Management model will give selected Medicare Prescription Drug Plans flexibility to design programs to improve health and lower costs, CMS announced Monday.

The five-year model will be tested in seven states starting in January 2017: Arizona, Indiana, Iowa, Mass., Pennsylvania Tennessee and Oregon.

According to new data released by the Centers for Medicare and Medicaid Services on Monday, the U.S. government has paid nearly $2.3 billion through July in incentives to close the coverage gap in 2015.

The Adventist Health System has agreed to pay $115 million to settle allegations that it paid physicians for patient referrals and that it filed claims with codes that made conditions seem more severe, according to the U.S. Department of Justice.

Medicare Advantage premiums will fall by 31 cents in 2016, the Centers for Medicare and Medicaid Services said on Monday amid surging enrollment to the privately managed program.

AMA sends letters Thursday to Secretary of Health and Human Services Sylvia Burwell and Office of Management and Budget Director Shaun Donovan.

One of the main ways the Affordable Care Act seeks to reduce health care costs is by encouraging doctors, hospitals and other health care providers to form networks that coordinate patient care and become eligible for bonuses when they deliver that care more efficiently.

Standard & Poor's has changed its outlook on nonprofit healthcare from 'negative' to 'stable,' the credit agency reported this week, as a flood of mergers and increased utilization due to Medicaid expansion continues to lift the sector.