Morning Briefing
Summaries of health policy coverage from major news organizations
CMS Proposes Crackdown On Inaccurate Medicare Advantage Provider Directories
The Centers for Medicare and Medicaid Services wants to shed new light on the operations of Medicare Advantage insurance companies and pharmacy benefit managers. The agency on Friday proposed a rule that would codify portions of the Consolidated Appropriations Act of 2026. (Tepper, 10/16)
More news about Medicare, Medicaid, and Obamacare —
Older adults shopping for Medicare coverage this fall could be in for some sticker shock: Premiums for some Part D prescription drug plans are rising by $50 or more a month next year, adding at least $600 to what people pay annually if they stick with their current coverage. (Lovelace Jr., 10/17)
Some conservative states that have rejected hardship exemptions for the new Medicaid requirements may be choosing not to due to political reasons, experts say. New federal work requirements for Medicaid, slated to come into effect on 1 January, mean that adults enrolled through the Affordable Care Act (ACA) Medicaid expansion will have to work, attend school, volunteer, or take part in another qualifying activity at least 80 hours a month to maintain their coverage. (Thomas, 10/18)
Cassidy Friedl remembers like a vivid dream the day her son Luca was born. She held him tight to her chest, hesitant to let go even when he needed to get weighed. She gazed at him in disbelief, taking in his chubby cheeks, big lips and orange hair that would eventually soften to strawberry blond. A few months later, Friedl began noticing something else about Luca. One of his eyes would sometimes drift inward. (Golvala, 10/18)
Is California doing enough to curtail Medi-Cal fraud? The state auditor doesn’t think so. A report released Thursday by Grant Parks, the state auditor, suggests the Department of Health Care Services is ill-equipped to stop pervasive abuse in Medi-Cal, a program that serves about 14 million Californians and pays out $200 billion annually. (Wiener, 10/16)
Ńîąóĺú´«Ă˝Ň•îl Health News: GOP Focuses On Fraud, Seeking To Redirect Voters’ Ire Over Healthcare Costs
Heading into the midterm elections, high healthcare costs rank among voters’ biggest concerns. But lately, there’s a twist giving the issue new momentum on campaign agendas: a focus on fraud in government health programs. The administration of President Donald Trump has used claims of widespread wrongdoing to justify investigations, suspensions of billions of dollars in payments to states, and the cancellation of Affordable Care Act health coverage for hundreds of thousands of people. (Armour, 10/19)
Virginia residents can begin shopping for 2027 health insurance plans through the state’s Marketplace on Nov. 1. Those with low to moderate incomes may be able to take advantage of state-funded subsidies this year that will lower monthly premiums. (Schabacker, 10/19)
Full Circle Health, where Dr. Hershman practices family medicine, has long been a last-hope safety net in the American health system. It is one of 1,400 networks known as federally qualified health centers with thousands of sites that receive federal funds to care for patients regardless of their ability to pay. Now their caseloads are growing, even as revenues are falling. With cuts to Medicaid mounting and the cost of Obamacare insurance plans soaring, the clinic’s doctors and counselors are going to new lengths to patch together care for people with complex medical issues who are underinsured and uninsured. (Hoffman, 10/19)
On affordability and hunger —
Food inflation, gas prices and cuts to federal benefits have created a “perfect storm” for food pantries, which have become vital parts of the family budget for millions of Americans. (Burch, 10/18)
