President Trump's administration will make one-time payments of $90 per person to help more than 20 million Medicare enrollees pay for their Part B premiums, costing approximately $2 billion. Critics have characterized the move as a political stunt.
The pharmaceutical industry's main lobbying group filed a lawsuit to block the Trump administration's GLOBE pilot program, which would benchmark US Medicare drug prices to lower international costs. The program aims to test 'most-favored nation' pricing policies.
CMS finalized the GLOBE demonstration program aimed at matching Medicare drug prices to international rates, but projected savings fell dramatically from $11.9 billion to $440 million after exempting 96% of drugmakers. Only four companies will participate after others signed separate pricing agreements.
The Centers for Medicare & Medicaid Services is preparing to reset Medicare laboratory payments in 2027, citing new private-payer data indicating the program currently pays substantially more than necessary for lab services.
Novo Nordisk announced its experimental drug CagriSema achieved 12.4% average weight loss in diabetes patients, surpassing Eli Lilly's rival treatment. Meanwhile, Eli Lilly reported 700,000 new seniors have begun GLP-1 treatments since Medicare coverage for obesity drugs launched in July, with 70% choosing Lilly medications.
HHS Office of Inspector General audits found that Humana and UnitedHealthcare Medicare Advantage plans exaggerated the health needs of members through upcoding practices, resulting in nearly $180 million in overpayments between 2020 and 2021.
Newly released records show Medicare's controversial AI-based prior authorization pilot program experienced lengthy treatment delays, technical problems, backlogs, and early warnings about contractor readiness issues.
A new modeling study published in The Lancet suggests that US Medicare's most-favored-nation pricing policy, which ties Medicare payments to prices in other high-income countries, could reduce US spending on brand-name drugs but incentivize pharmaceutical companies to increase prices or delay launches in lower-price markets like Europe.
The Centers for Medicare & Medicaid Services finalized a 2.3% payment increase for inpatient hospitals in fiscal year 2027 and introduced the first nationwide mandatory payment model for joint replacements starting in 2028. Hospital groups criticized the raise as inadequate and objected to the mandatory nature of the new model.
The Centers for Medicare & Medicaid Services has proposed cutting Medicare payments for drugs purchased under the 340B Drug Pricing Program in its 2027 rule, reigniting a long-standing dispute between safety-net hospitals and federal regulators over the program designed to help vulnerable populations access medications.
The Trump administration has proposed a new regulation through the Centers for Medicare & Medicaid Services targeting hospitals in the 340B Drug Pricing Program, aiming to prevent markups on discounted drugs for Medicare patients and potentially save consumers $1.1 billion next year.
Lawsuits over vision loss risks from Saxenda (liraglutide) emerge as Medicare begins covering GLP-1 medications for seniors over 65, raising questions about proper usage and safety in older populations.
Elevance Health has paid the federal government more than $342 million to settle allegations that it overcharged Medicare Advantage for years. The payment comes amid an ongoing billing probe into the major insurer, which covers approximately 2 million Medicare Advantage beneficiaries.
The Department of Justice has announced the creation of a new West Coast Health Care Fraud Strike Force to investigate fraud targeting Medicare and other government health programs in western states including Nevada, responding to criminals following retiree migration patterns.
The Centers for Medicare & Medicaid Services announced that its temporary BALANCE model program to cover GLP-1 drugs for obesity in Medicare will not launch as scheduled in January, effectively extending the current coverage approach.
The Centers for Medicare & Medicaid Services and FDA announced a new pathway to streamline Medicare coverage for breakthrough medical devices, cutting red tape and providing predictability for device manufacturers and faster patient access to life-changing technologies.
Jefferson Health filed a lawsuit against Aetna claiming its policy of reducing reimbursement for certain inpatient hospital stays violates federal law and their reimbursement contract. Aetna disputes Jefferson's claims.
A provision in the GOP's One Big Beautiful Bill Act will make an estimated 100,000 lawfully present immigrant seniors ineligible for Medicare coverage, ending benefits for individuals who paid into the system for years.
The Centers for Medicare & Medicaid Services finalized Medicare Advantage rates for 2027 with an $18.6 billion increase and reduced Star Ratings measures, leading to significant stock gains for major Medicare Advantage insurers.
The Centers for Medicare & Medicaid Services finalized its Contract Year 2027 Medicare Advantage and Part D rule, scaling back the number of measures used to grade health insurers while providing an extra $18.6 billion to plans. The rule promises simpler plan choices, better drug coverage, and lower costs for beneficiaries.
The Centers for Medicare & Medicaid Services announced that 23.1 million people selected health insurance plans through the Health Insurance Exchanges during 2026 open enrollment, maintaining near-record enrollment levels and demonstrating continued stability in the marketplace.
A Harvard-backed study found that the Inflation Reduction Act's drug provisions are helping Medicare beneficiaries stay on their medications. However, the reforms have not yet reduced overall healthcare costs or financial anxiety for beneficiaries.
