Medicare & Medicaid
The move makes South Dakota the 39th state, along with Washington, D.C., to adopt the ACA's Medicaid expansion.
The decrease is due in part to a permanent behavior assumption adjustment.
The list of the first 10 drugs covered under Part D selected for initial price applicability year 2026 will be announced September 1.
If a healthcare provider is out of compliance with CMS requirements, OIG may refer the matter to CMS.
The Enhancing Oncology Model offers additional payment for enhanced services to patients who are dually eligible for Medicare and Medicaid.
For hospital-based facilities, CMS projects an increase in total payments of 2.6%.
"If I were a hospital administrator right now, I'd have a tent outside of every entrance, (asking) do you know if you're still covered?"
Drug negotiation with manufacturers is government price fixing and is unconstitutional, groups say.
The science is there, but not the capital to get certain drugs to market. That means choices are being made, one says.
More than two-thirds of individuals who had Medicaid during the pandemic had their coverage terminated for procedural reasons, according to KFF.