medicare
31 stories related to this topic, newest first.
cnbc.comMedicare to Cover Wegovy and Zepbound for Obesity Treatment at $50 Monthly Copay Starting July 1
The temporary GLP-1 Bridge program will run through December 2027. Taxpayers will cover most costs for millions of new patients.
prnewswire.comCMS Finalizes Updates to Organ Transplant Access Model for Performance Year 2
The Centers for Medicare and Medicaid Services issued a final rule revising the Increasing Organ Transplant Access model and making a technical correction to regulatory text. The changes take effect July 1 2026 and will govern how participating kidney transplant hospitals are ass…
nbcnews.comJustice Department to Accelerate Review of Whistleblower Complaints on Benefits Fraud
The U.S. Department of Justice will shorten its review period for certain whistleblower complaints alleging fraud against federal benefits programs. Officials said the change aims to decide within 60 to 120 days whether to pursue litigation, investigate further, or dismiss cases.
manilatimes.netCMS Releases Updated Strategic Priorities at May 20 Event
The Centers for Medicare and Medicaid Services presented four strategic priorities during a May 20, 2026, discussion hosted by the Bipartisan Policy Center. The agency oversees coverage for more than 160 million Americans through Medicare, Medicaid, and the federal exchanges.
nypost.comDemocrats Introduce Resolutions to End Medicare AI Pilot Program
Democratic lawmakers have introduced resolutions in the House and Senate to repeal the WISeR model, a Medicare pilot using AI for prior authorization in six states. The program runs through 2031 and pays contractors based on cost savings from denied services.
Fox NewsAlzheimer's Blood Tests Face Medicare Coverage Limits
Medicare covers tau protein blood tests only after symptoms appear. New legislation would expand coverage for earlier detection.
Fox NewsReport Examines Medicare Scam Ads on Meta Platforms
A Center for Countering Digital Hate analysis reviewed more than 90,000 Meta ads and identified Medicare-related scam campaigns that generated 215 million impressions between March 2025 and March 2026. Meta stated it removed more than 159 million scam ads last year and disputes t…
upi.comSenate Democrats Propose Medicare Home Care Benefit
A group of Senate Democrats led by Sen. Ron Wyden proposed adding in-home care coverage to Medicare. The plan is the final part of a three-part health care package aimed at long-term care and workforce support.
Washington ExaminerSenate Democrats Outline Long-Term Care Goals for Future Medicare Expansion
Senate Democrats sent a letter outlining goals to expand home-based care under Medicare. The letter was sent ahead of the 2028 election cycle. It focuses on workforce pay, nursing home quality, and home care access.
upi.comSenate Democrats Propose Medicare Coverage for In-Home Long-Term Care
A group of Senate Democrats has proposed adding an in-home care benefit to Medicare. The plan forms the final part of a three-part health care package and does not include cost estimates or funding details.
usatoday.comSupreme Court Declines to Hear Pharma Challenges to Medicare Drug Price Program
The U.S. Supreme Court declined to review lawsuits filed by six pharmaceutical companies against the Medicare drug price negotiation program. The White House separately announced an expansion of its TrumpRx discount platform through partnerships with three prescription savings se…
manilatimes.netRural Health Gaps Limit Early Alzheimer's Detection
Rural communities face shortages of dementia specialists and limited access to diagnostic testing. New blood-based tests cleared by the Food and Drug Administration last year may reduce those barriers if Medicare coverage expands.
thenation.comMedicare Advantage brokers receive $10 billion in annual commissions
Medicare Advantage brokers collect about $10 billion yearly in commissions. The payments have drawn attention to the number of beneficiaries actually helped by the brokers.
forbes.comCongress Ends Medicare Reimbursement Pilot for CBD Products
A Medicare pilot program reimbursing patients for hemp-derived products faces uncertainty after a hemp ban passed by Congress last November. The ban would take effect in November and restrict most products containing any THC.
insidermonkey.comTrump Administration Authorizes Medicare Test Program for CBD
The Trump administration has authorized a test program allowing some Medicare patients to receive free cannabidiol, or CBD. The program will examine whether the cannabis compound can ease certain symptoms in older patients and reduce overall health care costs. It marks an initial…
abcnews.go.comFlorida Jury Convicts HealthSplash Owner in $1 Billion Medicare Fraud Scheme
A jury in the Southern District of Florida found the founder and owner of HealthSplash guilty of operating a platform that generated false doctors’ orders and prescriptions to bill Medicare and other federal health care programs for unnecessary equipment. The conviction forms par…
CnbcCMS Administrator Oz Joins CNBC to Discuss Healthcare Prior Authorization Coalition and Medicare Fraud
Dr. Mehmet Oz appeared on CNBC's Squawk Box to address the formation of an industry-wide coalition of 29 healthcare companies aimed at simplifying prior authorization. Oz, Administrator of the Centers for Medicare & Medicaid Services, highlighted efforts to combat healthcare frau…
New York PostTakeda to Pay $13.6 Million to Resolve False Claims Allegations Over Trintellix Kickbacks
Takeda Pharmaceuticals U.S.A. Inc. agreed to pay $13,670,921 to settle allegations that it paid kickbacks to physicians to induce prescriptions of its antidepressant Trintellix reimbursed by Medicare and other federal health care programs. The settlement requires the company to i…
Substrate placeholder — needs reviewTakeda Pharmaceuticals Agrees to Pay 13.6 Million to Resolve False Claims Allegations
Takeda Pharmaceuticals U.S.A. Inc. will pay $13,670,921 to settle allegations that it paid kickbacks to physicians to induce prescriptions of its antidepressant Trintellix to Medicare and other federal health care programs. The settlement removes the company from further liabilit…
Fox NewsCMS Imposes Six-Month Moratorium on New Hospice and Home Health Agency Medicare Enrollment
The Centers for Medicare and Medicaid Services halted new enrollments nationwide on May 13, 2026, to intensify fraud investigations. The pause, part of the Trump administration's anti-fraud efforts, follows suspensions of payments to hundreds of providers and the withholding of b…
theconservativetreehouse.comTrump Administration Launches 18-Month Medicare Pilot Capping Copays at $50 for Certain GLP-1 Weight-Loss Drugs
President Donald Trump and the Centers for Medicare & Medicaid Services unveiled an 18-month pilot that will allow qualifying Medicare Part D beneficiaries to obtain certain GLP-1 medications such as Wegovy for $50 a month beginning July 1, 2026. The program marks a major policy…
ksl.comUtah Podiatrist and Two Nurses Charged in $29 Million Medicare Fraud Scheme
A federal grand jury in St. George indicted podiatrist and two nurses for submitting false claims to Medicare for medically unnecessary skin substitute services. The charges trigger criminal proceedings in U.S. District Court that could require the defendants to repay millions in…
StatMedicare Spending on New Alzheimer’s Drugs Falls Below Projections
Medicare payments for recently approved Alzheimer’s medications are coming in well below earlier forecasts. A spokesperson for the Centers for Medicare and Medicaid Services said uptake of the drugs has been muted and the agency is not projecting significant spending in 2026 or 2…
foxnews.comMedicare Spending on Newly Approved Alzheimer’s Drugs Leqembi and Kisunla Far Below Initial Projections
Uptake of the recently approved intravenous Alzheimer’s medications has been far lower than anticipated, prompting Medicare to forecast no significant spending on Leqembi and Kisunla in 2026 or 2027. Two years ago the program projected billions of dollars annually on Leqembi alon…
StatMedicare Spending on Alzheimer’s Drugs Leqembi and Kisunla Far Below Initial Projections
Uptake of the recently approved intravenous medications has been far lower than anticipated, prompting the Centers for Medicare and Medicaid Services to project no significant spending in 2026 or 2027. The muted adoption marks a sharp reversal from projections made two years ago.
manilatimes.netMedicare to Test $50 Monthly Co-Pay for GLP-1 Weight Loss Drugs in New Pilot Program
The Centers for Medicare and Medicaid Services announced a two-year demonstration program that will allow certain enrollees to access FDA-approved GLP-1 medications for weight loss at a fixed $50 monthly co-pay with no deductible. The Medicare GLP-1 Bridge program runs from July…
foxnews.comTwo men sentenced to prison in $522 million genetic testing fraud scheme
A federal court sentenced two men to 151 months and 36 months in prison for submitting over $522 million in fraudulent claims for medically unnecessary genetic tests. The sentences advance the Justice Department’s National Fraud Enforcement Division initiative that has now reache…
NprMedicare to Test 18-Month GLP-1 Pilot for Weight Loss Drugs Starting July 2026
The Centers for Medicare & Medicaid Services will begin a short-term pilot on July 1, 2026, allowing eligible beneficiaries to obtain certain GLP-1 medications for weight loss at a flat $50 copayment. The 18-month program bridges to a potential longer-term initiative in 2028 afte…
rd.comUS Sues Florida Immunologist for False Medicare Claims on Immune Drugs
The Justice Department filed a civil complaint against Dr. Kevin Rosenbach and his Naples practice for submitting fraudulent claims for subcutaneous immune globulins to Medicare Part B. The action seeks to recover federal funds and impose penalties under the False Claims Act.
sbs.com.auAverage Out-of-Pocket Cost for First Australian Dermatology Visit: $230 (2025 Report)
A new Cleanbill report details average out-of-pocket costs for dermatology appointments in Australia at $230 for first visits and nearly $190 for follow-ups, with nationwide increases of almost $18 and $20 respectively over one year. The findings, based on 322 clinics, highlight…
Substrate placeholder — needs reviewCongressional Testimony Highlights Hospice Fraud Cases in California Involving Empty Facilities and False Enrollments
Witnesses testified before the House Ways and Means Committee on widespread hospice fraud in California, including empty facilities and improper enrollments. A psychotherapist described being falsely listed in hospice, denying her Medicare access. Federal crackdowns have suspende…